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Guo L, Cid A, Cucci J, Kunkel B, Defeis L, Matthews M. Acu-URO17 is a highly sensitive and specific bladder cancer biomarker. BJUI COMPASS 2024; 5:497-501. [PMID: 38751950 PMCID: PMC11090771 DOI: 10.1002/bco2.338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 02/01/2024] [Indexed: 05/18/2024] Open
Abstract
Objective This study evaluates the efficacy of Acu-URO17, a highly sensitive and specific immunocytochemistry (ICC) test targeting Keratin 17, in comparison to urine cytology and UroVysion™ fluorescence in situ hybridization (FISH) for detecting bladder cancer cells in voided urine specimens. Methods Acupath conducted a large-scale comparison study using 2378 voided urine specimens. Acu-URO17, urine cytology and UroVysion™ FISH were performed on these specimens according to standardized protocols. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for Acu-URO17 in comparison to urine cytology and UroVysion™ FISH. Results In cases diagnosed with high-grade urothelial cancer via urine cytology, Acu-URO17 demonstrated a sensitivity of 96% and a specificity of 82%. When compared to UroVysion™ FISH results, Acu-URO17 exhibited a sensitivity of 97.1% and a specificity of 77.8%, surpassing the sensitivity of UroVysion™ FISH (57.1%). Notably, Acu-URO17 showed a high NPV of 99.9%, indicating its reliability in confirming negative urine cytology results and risk-stratifying atypical and suspicious cytology results. Conclusion The results of this large-scale prospective study support Acu-URO17 as a clinically relevant, non-invasive and cost-effective tool for detecting bladder cancer cells in voided urine specimens. Its high sensitivity, specificity and NPV make it a valuable adjunct to urine cytology and UroVysion™ FISH in the diagnosis and management of urothelial carcinoma (UC).
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Affiliation(s)
- Liwu Guo
- Acupath Laboratories IncPlainviewNew YorkUSA
| | | | - John Cucci
- Acupath Laboratories IncPlainviewNew YorkUSA
| | | | - Lisa Defeis
- Acupath Laboratories IncPlainviewNew YorkUSA
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Furuya H, Sakatani T, Tanaka S, Murakami K, Waldron RT, Hogrefe W, Rosser CJ. Bladder cancer risk stratification with the Oncuria 10-plex bead-based urinalysis assay using three different Luminex xMAP instrumentation platforms. J Transl Med 2024; 22:8. [PMID: 38167321 PMCID: PMC10763405 DOI: 10.1186/s12967-023-04811-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 12/16/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND No single marker of bladder cancer (BC) exists in urine samples with sufficient accuracy for disease diagnosis and treatment monitoring. The multiplex Oncuria BC assay noninvasively quantifies the concentration of 10 protein analytes in voided urine samples to quickly generate a unique molecular profile with proven BC diagnostic and treatment-tracking utility. Test adoption by diagnostic and research laboratories mandates reliably reproducible assay performance across a variety of instrumentation platforms used in different laboratories. METHODS We compared the performance of the clinically validated Oncuria BC multiplex immunoassay when data output was generated on three different analyzer systems. Voided urine samples from 36 subjects (18 with BC and 18 Controls) were reacted with Oncuria test reagents in three 96-well microtiter plates on Day 1, and consecutively evaluated on the LED/image-based MagPix, and laser/flow-based Luminex 200 and FlexMap 3D (all xMAP instruments from Luminex Corp., Austin, TX) on Day 2. The BC assay uses magnetic bead-based fluorescence technology (xMAP, Multi-analyte profiling; Luminex) to simultaneously quantify 10 protein analytes in urine specimens [i.e., angiogenin (ANG), apolipoprotein E (ApoE), carbonic anhydrase IX (CA9), CXCL8/interleukin-8 (IL-8), matrix metalloproteinase-9 (MMP-9), matrix metalloproteinase-10 (MMP-10), serpin A1/alpha-1 anti-trypsin (A1AT), serpin E1/plasminogen activator inhibitor-1 (PAI-1), CD138/syndecan-1 (SDC1), and vascular endothelial growth factor-A (VEGF-A)]. All three analyzers quantify fluorescence signals generated by the Oncuria assay. RESULTS All three platforms categorized all 10 analytes in identical samples at nearly identical concentrations, with variance across systems typically < 5%. While the most contemporary instrument, the FlexMap 3D, output higher raw fluorescence values than the two comparator systems, standard curve slopes and analyte concentrations determined in urine samples were concordant across all three units. Forty-four percent of BC samples registered ≥ 1 analyte above the highest standard concentration, i.e., A1AT (n = 7/18), IL-8 (n = 5), and/or ANG (n = 2), while only one control sample registered an analyte (A1AT) above the highest standard concentration. CONCLUSION Multiplex BC assays generate detailed molecular signatures useful for identifying BC, predicting treatment responsiveness, and tracking disease progression and recurrence. The similar performance of the Oncuria assay across three different analyzer systems supports test adaptation by clinical and research laboratories using existing xMAP platforms. TRIAL REGISTRATION This study was registered at ClinicalTrials.gov as NCT04564781, NCT03193528, NCT03193541, and NCT03193515.
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Affiliation(s)
- Hideki Furuya
- Cedars‑Sinai Medical Center, Samuel Oschin Comprehensive Cancer Institute, 110 N. George Burns Rd, Davis 2025, Los Angeles, CA, 90048, USA.
- Department of Biomedical Sciences, Cedars‑Sinai Medical Center, Los Angeles, CA, USA.
| | - Toru Sakatani
- Cedars‑Sinai Medical Center, Samuel Oschin Comprehensive Cancer Institute, 110 N. George Burns Rd, Davis 2025, Los Angeles, CA, 90048, USA
- Department of Urology, Cedars‑Sinai Medical Center, Los Angeles, CA, USA
| | - Sunao Tanaka
- Cedars‑Sinai Medical Center, Samuel Oschin Comprehensive Cancer Institute, 110 N. George Burns Rd, Davis 2025, Los Angeles, CA, 90048, USA
| | - Kaoru Murakami
- Cedars‑Sinai Medical Center, Samuel Oschin Comprehensive Cancer Institute, 110 N. George Burns Rd, Davis 2025, Los Angeles, CA, 90048, USA
- Department of Urology, Cedars‑Sinai Medical Center, Los Angeles, CA, USA
| | - Richard T Waldron
- Department of Medicine, Cedars‑Sinai Medical Center, Los Angeles, CA, USA
| | | | - Charles J Rosser
- Cedars‑Sinai Medical Center, Samuel Oschin Comprehensive Cancer Institute, 110 N. George Burns Rd, Davis 2025, Los Angeles, CA, 90048, USA
- Department of Urology, Cedars‑Sinai Medical Center, Los Angeles, CA, USA
- Nonagen Bioscience Corp., Los Angeles, CA, USA
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Furuya H, Sakatani T, Tanaka S, Murakami K, Waldron RT, Hogrefe W, Rosser CJ. Bladder cancer risk stratification with the Oncuria 10-plex bead-based urinalysis assay using three different Luminex xMAP instrumentation platforms. RESEARCH SQUARE 2023:rs.3.rs-3635581. [PMID: 38045238 PMCID: PMC10690323 DOI: 10.21203/rs.3.rs-3635581/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Background No single marker of bladder cancer (BC) exists in urine samples with sufficient accuracy for disease diagnosis and treatment monitoring. The multiplex Oncuria BC assay noninvasively quantifies the concentration of 10 protein analytes in voided urine samples to quickly generate a unique molecular profile with proven BC diagnostic and treatment-tracking utility. Test adoption by diagnostic and research laboratories mandates reliably reproducible assay performance across a variety of instrumentation platforms used in different laboratories. Methods We compared the performance of the clinically validated Oncuria BC multiplex immunoassay when data output was generated on three different analyzer systems. Voided urine samples from 36 subjects (18 with BC and 18 Controls) were reacted with Oncuria test reagents in three 96-well microtiter plates on Day 1, and consecutively evaluated on the LED/image-based MagPix, and laser/flow based Luminex 200 and FlexMap 3D (all xMAP instruments from Luminex Corp., Austin, TX) on Day 2. The BC assay uses magnetic bead-based fluorescence technology (xMAP, Multi-analyte profiling; Luminex) to simultaneously quantify 10 protein analytes in urine specimens [i.e., angiogenin (ANG), apolipoprotein E (ApoE), carbonic anhydrase IX (CA9), CXCL8/interleukin-8 (IL-8), matrix metalloproteinase-9 (MMP-9), matrix metalloproteinase-10 (MMP-10), serpin A1/alpha-1 anti-trypsin (A1AT), serpin E1/plasminogen activator inhibitor-1 (PAI-1), CD138/syndecan-1 (SDC1), and vascular endothelial growth factor-A (VEGF-A)]. Results All three platforms categorized all 10 analytes in identical samples at nearly identical concentrations, with variance across systems typically <5%. While the most contemporary instrument, the FlexMap 3D, output higher raw fluorescence values than the two comparator systems, standard curve slopes and analyte concentrations determined in urine samples were concordant across all three units. Forty-four percent of BC samples registered ≥1 analyte above the highest standard concentration, i.e., A1AT (n=7/18), IL-8 (n=5), and/or ANG (n=2). In Controls, A1AT was higher in one sample. Conclusion Multiplex BC assays generate detailed molecular signatures useful for identifying BC, predicting treatment esponsiveness, and tracking disease progression and recurrence. The similar performance of the Oncuria assay across three different analyzer systems supports test adaptation by clinical and research laboratories using existing xMAP platforms. Trial Registration This study was registered at ClinicalTrials.gov as NCT04564781, NCT03193528, NCT03193541, and NCT03193515.
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Affiliation(s)
| | - Toru Sakatani
- Cedars-Sinai Comprehensive Cancer Center: Cedars-Sinai Medical Center Samuel Oschin Comprehensive Cancer Institute
| | - Sunao Tanaka
- Cedars-Sinai Comprehensive Cancer Center: Cedars-Sinai Medical Center Samuel Oschin Comprehensive Cancer Institute
| | - Kaoru Murakami
- Cedars-Sinai Comprehensive Cancer Center: Cedars-Sinai Medical Center Samuel Oschin Comprehensive Cancer Institute
| | | | | | - Charles J Rosser
- Cedars-Sinai Medical Center Samuel Oschin Comprehensive Cancer Institute
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