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Hemenway G, Anker JF, Riviere P, Rose BS, Galsky MD, Ghatalia P. Advancements in Urothelial Cancer Care: Optimizing Treatment for Your Patient. Am Soc Clin Oncol Educ Book 2024; 44:e432054. [PMID: 38771987 DOI: 10.1200/edbk_432054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2024]
Abstract
The standard treatment paradigm for muscle invasive bladder cancer has been neoadjuvant cisplatin-based chemotherapy followed by radical cystectomy. However, efforts are ongoing to personalize treatment by incorporating biomarkers to better guide treatment selection. In addition, bladder preservation strategies are aimed at avoiding cystectomy in well-selected patients. Similarly, in the metastatic urothelial cancer space, the standard frontline treatment option of platinum-based chemotherapy has changed with the availability of data from EV-302 trial, making the combination of enfortumab vedotin (EV) and pembrolizumab the preferred first-line treatment option. Here, we examine the optimization of treatment intensity and sequencing, focusing on the challenges and opportunities associated with EV/pembrolizumab therapy, including managing toxicities and exploring alternative dosing approaches. Together, these articles provide a comprehensive overview of contemporary strategies in bladder cancer management, highlighting the importance of individualized treatment approaches, ongoing research, and multidisciplinary collaboration to improve patient outcomes in this complex disease landscape.
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Affiliation(s)
| | - Jonathan F Anker
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Paul Riviere
- UCSD Radiation Medicine and Applied Sciences, San Diego, CA
| | - Brent S Rose
- UCSD Radiation Medicine and Applied Sciences, San Diego, CA
| | - Matthew D Galsky
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY
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2
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Pérez González S, Heredia-Soto V, Girón de Francisco M, Pérez-Fernández E, Casans-Francés R, Mendiola Sabio M, González-Peramato P. Telomerase Reverse Transcriptase-Promoter Mutation in Young Patients with Bladder Tumors. Curr Issues Mol Biol 2024; 46:2845-2855. [PMID: 38666908 PMCID: PMC11049539 DOI: 10.3390/cimb46040178] [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: 02/13/2024] [Revised: 03/20/2024] [Accepted: 03/21/2024] [Indexed: 04/28/2024] Open
Abstract
The TERT (Telomerase Reverse Transcriptase) gene promoter mutation is one of the most prevalent mutations in urothelial bladder tumors and this mutation is related to bladder tumor progression. Our purpose was to evaluate the presence of this mutation in a population of patients who were first diagnosed at age ≤ 40 years and to examine its relationship with tumor characteristics and progression. A molecular study was performed to detect the two most prevalent mutations in the TERT promoter (C228T and C250T). The study included 29 patients, with a mean follow-up of 152 months. There were no statistically significant differences in the clinical or tumor characteristics according to the presence or absence of the mutation. Although the mutation group showed poorer recurrence-free survival (RFS), there was no statistically significant difference and there was no difference in progression-free survival by group (p > 0.05). The pTERT mutations in bladder tumor cells occurred less frequently in younger patients than in older patients, a finding that could indicate different mechanisms of carcinogenesis. The trend towards lower RFS in patients with mutated pTERT needs to be confirmed by further studies, given the small number of patients included in these studies due to the low incidence of bladder tumors in this age group.
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Affiliation(s)
| | - Victoria Heredia-Soto
- Translational Oncology Research Laboratory, Hospital La Paz Institute for Health Research (IdiPAZ), 28046 Madrid, Spain
- Center for Biomedical Research in the Cancer Network (CIBERONC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | | | | | - Rubén Casans-Francés
- Department of Anesthesia and Pain Medicine, Infanta Elena University Hospital, 28342 Madrid, Spain
| | - Marta Mendiola Sabio
- Center for Biomedical Research in the Cancer Network (CIBERONC), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Molecular Pathology and Therapeutic Targets Group, Hospital La Paz Institute for Health Research (IdiPAZ), 28046 Madrid, Spain
| | - Pilar González-Peramato
- Department of Pathology, La Paz University Hospital, 28046 Madrid, Spain
- Faculty of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain
- Cellular Engineering Laboratory, Hospital La Paz Institute for Health Research (IdiPAZ), 28046 Madrid, Spain
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3
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Wu S, Li R, Jiang Y, Yu J, Zheng J, Li Z, Li M, Xin K, Wang Y, Xu Z, Li S, Chen X. Liquid biopsy in urothelial carcinoma: Detection techniques and clinical applications. Biomed Pharmacother 2023; 165:115027. [PMID: 37354812 DOI: 10.1016/j.biopha.2023.115027] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 06/13/2023] [Accepted: 06/14/2023] [Indexed: 06/26/2023] Open
Abstract
The types of urothelial carcinoma (UC) include urothelial bladder cancer and upper tract urothelial carcinoma. Current diagnostic techniques cannot meet the needs of patients. Liquid biopsy is an accurate method of determining the molecular profile of UC and is a cutting-edge and popular technique that is expected to complement existing detection techniques and benefit patients with UC. Circulating tumor cells, cell-free DNA, cell-free RNA, extracellular vesicles, proteins, and metabolites can be found in the blood, urine, or other bodily fluids and are examined during liquid biopsies. This article focuses on the components of liquid biopsies and their clinical applications in UC. Liquid biopsies have tremendous potential in multiple aspects of precision oncology, from early diagnosis and treatment monitoring to predicting prognoses. They may therefore play an important role in the management of UC and precision medicine.
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Affiliation(s)
- Siyu Wu
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, China
| | - Rong Li
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, China
| | - Yuanhong Jiang
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, China
| | - Jiazheng Yu
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, China
| | - Jianyi Zheng
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, China
| | - Zeyu Li
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, China
| | - Mingyang Li
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, China
| | - Kerong Xin
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, China
| | - Yang Wang
- Department of Gynecology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, Liaoning 110042, China.
| | - Zhenqun Xu
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, China.
| | - Shijie Li
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, China.
| | - Xiaonan Chen
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, China.
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4
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Rose KM, Huelster HL, Meeks JJ, Faltas BM, Sonpavde GP, Lerner SP, Ross JS, Spiess PE, Grass GD, Jain RK, Kamat AM, Vosoughi A, Wang L, Wang X, Li R. Circulating and urinary tumour DNA in urothelial carcinoma - upper tract, lower tract and metastatic disease. Nat Rev Urol 2023; 20:406-419. [PMID: 36977797 DOI: 10.1038/s41585-023-00725-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2023] [Indexed: 03/30/2023]
Abstract
Precision medicine has transformed the way urothelial carcinoma is managed. However, current practices are limited by the availability of tissue samples for genomic profiling and the spatial and temporal molecular heterogeneity observed in many studies. Among rapidly advancing genomic sequencing technologies, non-invasive liquid biopsy has emerged as a promising diagnostic tool to reproduce tumour genomics, and has shown potential to be integrated in several aspects of clinical care. In urothelial carcinoma, liquid biopsies such as plasma circulating tumour DNA (ctDNA) and urinary tumour DNA (utDNA) have been investigated as a surrogates for tumour biopsies and might bridge many shortfalls currently faced by clinicians. Both ctDNA and utDNA seem really promising in urothelial carcinoma diagnosis, staging and prognosis, response to therapy monitoring, detection of minimal residual disease and surveillance. The use of liquid biopsies in patients with urothelial carcinoma could further advance precision medicine in this population, facilitating personalized patient monitoring through non-invasive assays.
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Affiliation(s)
- Kyle M Rose
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center, Tampa, FL, USA
| | - Heather L Huelster
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center, Tampa, FL, USA
| | - Joshua J Meeks
- Department of Urology, Northwestern University, Chicago, IL, USA
| | - Bishoy M Faltas
- Department of Hematology/Oncology, Weill-Cornell Medicine, New York, NY, USA
| | - Guru P Sonpavde
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Seth P Lerner
- Department of Urology, Baylor College of Medicine, Houston, TX, USA
| | - Jeffrey S Ross
- Foundation Medicine, Inc, Cambridge, MA, USA
- Departments of Urology and Pathology, Upstate Medical University, Syracuse, NY, USA
| | - Philippe E Spiess
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center, Tampa, FL, USA
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center, Tampa, FL, USA
| | - G Daniel Grass
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center, Tampa, FL, USA
| | - Rohit K Jain
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center, Tampa, FL, USA
| | - Ashish M Kamat
- Department of Urology, MD Anderson Cancer Center, Houston, TX, USA
| | - Aram Vosoughi
- Department of Anatomic Pathology, H. Lee Moffitt Cancer Center, Tampa, FL, USA
| | - Liang Wang
- Department of Tumour Biology, H. Lee Moffitt Cancer Center, Tampa, FL, USA
| | - Xuefeng Wang
- Department of Biostatistics/Bioinformatics, H. Lee Moffitt Cancer Center, Tampa, FL, USA
| | - Roger Li
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center, Tampa, FL, USA.
- Department of Immunology, H. Lee Moffitt Cancer Center, Tampa, FL, USA.
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5
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Cheng L, Zhang S, Wang M, Lopez-Beltran A. Biological and clinical perspectives of TERT promoter mutation detection on bladder cancer diagnosis and management. Hum Pathol 2023; 133:56-75. [PMID: 35700749 DOI: 10.1016/j.humpath.2022.06.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 06/05/2022] [Indexed: 02/08/2023]
Abstract
The telomerase reverse transcriptase (TERT) promoter mutations are associated with increased TERT mRNA and TERT protein levels, telomerase activity, and shorter but stable telomere length. TERT promoter mutation is the most common mutation that occurs in approximately 60-80% of patients with bladder cancer. The TERT promoter mutations occur in a wide spectrum of urothelial lesions, including benign urothelial proliferation and tumor-like conditions, benign urothelial tumors, premalignant and putative precursor lesions, urothelial carcinoma and its variants, and nonurothelial malignancies. The prevalence and incidence of TERT promoter mutations in a total of 7259 cases from the urinary tract were systematically reviewed. Different platforms of TERT promoter mutation detection were presented. In this review, we also discussed the significance and clinical implications of TERT promoter mutation detection in urothelial tumorigenesis, surveillance and early detection, diagnosis, differential diagnosis, prognosis, prediction of treatment responses, and clinical outcome. Identification of TERT promoter mutations from urine or plasma cell-free DNA (liquid biopsy) will facilitate bladder cancer screening program and optimal clinical management. A better understanding of TERT promoter mutation and its pathway would open new therapeutic avenues for patients with bladder cancer.
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Affiliation(s)
- Liang Cheng
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, 46202, USA; Department of Pathology and Laboratory Medicine, Warren Alpert Medical School of Brown University and Lifespan Academic Medical Center, Providence, RI, 02903, USA.
| | - Shaobo Zhang
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Mingsheng Wang
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Antonio Lopez-Beltran
- Department of Morphological Sciences, University of Cordoba Medical School, Cordoba, E-14004, Spain
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Development of a Sensitive Digital Droplet PCR Screening Assay for the Detection of GPR126 Non-Coding Mutations in Bladder Cancer Urine Liquid Biopsies. Biomedicines 2023; 11:biomedicines11020495. [PMID: 36831030 PMCID: PMC9953558 DOI: 10.3390/biomedicines11020495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/06/2023] [Accepted: 02/07/2023] [Indexed: 02/11/2023] Open
Abstract
Recent whole-genome sequencing studies identified two novel recurrent mutations in the enhancer region of GPR126 in urothelial bladder cancer (UBC) tumor samples. This mutational hotspot is the second most common after the TERT promoter in UBC. The aim of the study was to develop a digital droplet PCR screening assay for the simultaneous detection of GPR126 mutations in a single tube. Its performance combined with TERT promoter mutation analysis was evaluated in urine of healthy volunteers (n = 50) and patients with cystitis (n = 22) and UBC (n = 70). The developed assay was validated using DNA constructs carrying the studied variants. None of the mutations were detected in control and cystitis group samples. GPR126 mutations were observed in the urine of 25/70 UBC patients (area under the ROC curve (AUC) of 0.679; mutant allele fraction (MAF) of 21.61 [8.30-44.52] %); TERT mutations-in 40/70 (AUC of 0.786; MAF = 28.29 [19.03-38.08] %); ≥1 mutation-in 47/70 (AUC of 0.836)). The simultaneous presence of GPR126 and TERT mutations was observed in 18/70 cases, with no difference in MAFs for the paired samples (31.96 [14.78-47.49] % vs. 27.13 [17.00-37.62] %, p = 0.349, respectively). The combined analysis of these common non-coding mutations in urine allows the sensitive and non-invasive detection of UBC.
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7
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Liu T, Li S, Xia C, Xu D. TERT promoter mutations and methylation for telomerase activation in urothelial carcinomas: New mechanistic insights and clinical significance. Front Immunol 2023; 13:1071390. [PMID: 36713366 PMCID: PMC9877314 DOI: 10.3389/fimmu.2022.1071390] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 12/28/2022] [Indexed: 01/15/2023] Open
Abstract
Telomerase, an RNA-dependent DNA polymerase synthesizing telomeric TTAGGG sequences, is primarily silent in normal human urothelial cells (NHUCs), but widely activated in urothelial cell-derived carcinomas or urothelial carcinomas (UCs) including UC of the bladder (UCB) and upper track UC (UTUC). Telomerase activation for telomere maintenance is required for the UC development and progression, and the key underlying mechanism is the transcriptional de-repression of the telomerase reverse transcriptase (TERT), a gene encoding the rate-limiting, telomerase catalytic component. Recent mechanistic explorations have revealed important roles for TERT promoter mutations and aberrant methylation in activation of TERT transcription and telomerase in UCs. Moreover, these TERT-featured genomic and epigenetic alterations have been evaluated for their usefulness in non-invasive UC diagnostics, recurrence monitoring, outcome prediction and response to treatments such as immunotherapy. Importantly, the detection of the mutated TERT promoter and TERT mRNA as urinary biomarkers holds great promise for urine-based UC liquid biopsy. In the present article, we review recent mechanistic insights into altered TERT promoter-mediated telomerase activation in UCs and discuss potential clinical implications. Specifically, we compare differences in senescence and transformation between NHUCs and other types of epithelial cells, address the interaction between TERT promoter mutations and other factors to affect UC progression and outcomes, evaluate the impact of TERT promoter mutations and TERT-mediated activation of human endogenous retrovirus genes on UC immunotherapy including Bacillus Calmette-Guérin therapy and immune checkpoint inhibitors. Finally, we suggest the standardization of a TERT assay and evaluation system for UC clinical practice.
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Affiliation(s)
- Tiantian Liu
- Department of Pathology, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Shihong Li
- Department of Pathology, Maternal and Child Health Hospital of Liaocheng, Liaocheng, China
| | - Chuanyou Xia
- Department of Urology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China,*Correspondence: Chuanyou Xia, ; Dawei Xu,
| | - Dawei Xu
- Department of Medicine, Bioclinicum and Center for Molecular Medicine (CMM), Karolinska Institutet and Karolinska University Hospital Solna, Stockholm, Sweden,*Correspondence: Chuanyou Xia, ; Dawei Xu,
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8
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Salfer B, Li F, Wong DT, Zhang L. Urinary Cell-Free DNA in Liquid Biopsy and Cancer Management. Clin Chem 2022; 68:1493-1501. [PMID: 36213956 PMCID: PMC10423312 DOI: 10.1093/clinchem/hvac122] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 06/30/2022] [Indexed: 11/14/2022]
Abstract
BACKGROUND The current methodology used to detect, diagnose, and monitor many types of cancers requires invasive tissue biopsy testing. Recently, liquid biopsy using blood, plasma, urine, saliva, and various other bodily fluids has shown utility to solve many issues associated with tissue biopsy. Blood/plasma has received most of the attention within the liquid biopsy field, however, obtaining blood samples from patients is still somewhat invasive and requires trained professionals. Using urine to detect cell-free DNA cancer biomarkers offers a truly non-invasive sampling method that can be easily and reproducibly conducted by patients. CONTENT Novel technologies and approaches have made the detection of small quantities of cell-free tumor DNA of varying lengths possible. Recent studies using urine circulating tumor DNA to detect cancer mutations and other biomarkers have shown sensitivity comparable to blood/plasma cell-free DNA liquid biopsy for many cancer types. Thus, urine cell-free DNA liquid biopsy may replace or provide supplementary information to tissue/blood biopsies. Further investigation with larger patient cohorts and standardization of pre-analytical factors is necessary to determine the utility of urine cell-free DNA liquid biopsy for cancer detection, diagnosis, and monitoring in a clinical setting. SUMMARY In this mini-review we discuss the biological aspects of cell-free DNA in urine, numerous studies using urine cell-free DNA to detect urological cancers, and recent studies using urine cell-free DNA to detect and monitor non-urological cancers including lung, breast, colorectal, and other cancers.
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Affiliation(s)
- Blake Salfer
- Department of Pathology and Laboratory Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA
| | - Feng Li
- School of Dentistry, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA
| | - David T.W. Wong
- School of Dentistry, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA
| | - Liying Zhang
- Department of Pathology and Laboratory Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA
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El Ahanidi H, El Azzouzi M, Hafidi Alaoui C, Tetou M, Bensaid M, Chaoui I, Benbacer L, Hassan I, Oukabli M, Michaud K, Ameur A, Al Bouzidi A, El Mzibri M, Jandus C, Attaleb M. Immune Checkpoint and Telomerase Crosstalk Is Mediated by miRNA-138 in Bladder Cancer. Front Oncol 2022; 11:795242. [PMID: 35223454 PMCID: PMC8874320 DOI: 10.3389/fonc.2021.795242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 12/21/2021] [Indexed: 11/15/2022] Open
Abstract
Background Tumor recurrence and progression in non-muscle invasive bladder cancer (NMIBC), therapy failure, and severe side effects in muscle invasive bladder cancer (MIBC) are the major challenges in the clinical management of bladder cancer (BC). Here, we identify new molecular targetable signatures to improve BC patients’ stratification and the outcome of current immunotherapies. Material and Methods In a prospective cohort of 70 BC patients, we assessed the genetic and molecular regulation of TERT in maintaining telomere length in parallel to immune checkpoint and microRNA expression. Results TERT was undetectable in healthy bladder tissues but upregulated in invasive BC stages and high tumor grade. Its expression was linked with the combined effect of the C250T mutation and THOR hypermethylation, associated with progressing tumors and maintaining of telomere length. In the same cohort, PD-L1 scored highest in NMIBC, while PD-L2 was upregulated in MIBC. We also show that miR-100-5p and 138-5p were highly expressed in healthy bladder specimens and cell line, while expression decreased in the BC tissues and BC cell lines. In line with the binding prediction for these miRNAs on target genes, miRs 100-5p and 138-5p expression strongly inverse correlated with TERT, PD-L1, and PD-L2 expression, but not PD1. Conclusion We identify a loop involving TERT, PD1-ligands, and miR-138-5p in BC, that might represent not only a useful biomarker for improved diagnosis and patients’ stratification but also as a promising axis that might be therapeutically targeted in situ.
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Affiliation(s)
- Hajar El Ahanidi
- Biology and Medical Research Unit, Centre National de l'Energie, des Sciences et Techniques Nucleaires (CNESTEN), Rabat, Morocco
- Rabat Medical and Pharmacy School, Mohammed V University in Rabat, Rabat, Morocco
- Department of Pathology and Immunology, University of Geneva, Geneva, Switzerland
| | - Meryem El Azzouzi
- Biology and Medical Research Unit, Centre National de l'Energie, des Sciences et Techniques Nucleaires (CNESTEN), Rabat, Morocco
- Rabat Medical and Pharmacy School, Mohammed V University in Rabat, Rabat, Morocco
| | - Chaimae Hafidi Alaoui
- Biology and Medical Research Unit, Centre National de l'Energie, des Sciences et Techniques Nucleaires (CNESTEN), Rabat, Morocco
- Faculty of Sciences, Mohammed V University in Rabat, Rabat, Morocco
| | - Mohammed Tetou
- Rabat Medical and Pharmacy School, Mohammed V University in Rabat, Rabat, Morocco
- Military Hospital Mohammed V, Rabat, Morocco
| | | | - Imane Chaoui
- Biology and Medical Research Unit, Centre National de l'Energie, des Sciences et Techniques Nucleaires (CNESTEN), Rabat, Morocco
| | - Laila Benbacer
- Biology and Medical Research Unit, Centre National de l'Energie, des Sciences et Techniques Nucleaires (CNESTEN), Rabat, Morocco
| | - Ilias Hassan
- Rabat Medical and Pharmacy School, Mohammed V University in Rabat, Rabat, Morocco
- Military Hospital Mohammed V, Rabat, Morocco
| | - Mohamed Oukabli
- Rabat Medical and Pharmacy School, Mohammed V University in Rabat, Rabat, Morocco
- Military Hospital Mohammed V, Rabat, Morocco
| | - Katarzyna Michaud
- University Center of Legal Medicine Lausanne-Geneva, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Ahmed Ameur
- Biology and Medical Research Unit, Centre National de l'Energie, des Sciences et Techniques Nucleaires (CNESTEN), Rabat, Morocco
- Military Hospital Mohammed V, Rabat, Morocco
| | | | - Mohammed El Mzibri
- Biology and Medical Research Unit, Centre National de l'Energie, des Sciences et Techniques Nucleaires (CNESTEN), Rabat, Morocco
| | - Camilla Jandus
- Department of Pathology and Immunology, University of Geneva, Geneva, Switzerland
- Ludwig Institute for Cancer Research, Lausanne Branch, Lausanne, Switzerland
| | - Mohammed Attaleb
- Biology and Medical Research Unit, Centre National de l'Energie, des Sciences et Techniques Nucleaires (CNESTEN), Rabat, Morocco
- *Correspondence: Mohammed Attaleb, ;
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10
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Gordon NS, Baxter LA, Goel A, Arnold R, Kaur B, Liu W, Pirrie SJ, Hussain S, Viney R, Ford D, Zarkar A, Wood MA, Mitin T, Thompson RF, James ND, Ward DG, Bryan RT. Urine DNA for monitoring chemoradiotherapy response in muscle-invasive bladder cancer: a pilot study. BJU Int 2022; 129:32-34. [PMID: 34491610 DOI: 10.1111/bju.15589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
MESH Headings
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Biomarkers, Tumor/urine
- Cetuximab/administration & dosage
- Chemoradiotherapy
- Clinical Trials, Phase I as Topic
- Clinical Trials, Phase II as Topic
- DNA, Neoplasm/analysis
- DNA, Neoplasm/urine
- Fluorouracil/administration & dosage
- Humans
- Liquid Biopsy
- Mitomycin/administration & dosage
- Muscle, Smooth/pathology
- Mutation
- Neoplasm Invasiveness
- Neoplasm Recurrence, Local/genetics
- Neoplasm Recurrence, Local/urine
- Pilot Projects
- Receptor, Fibroblast Growth Factor, Type 3/genetics
- Sequence Analysis, DNA
- Telomerase/genetics
- Treatment Outcome
- Tumor Suppressor Protein p53/genetics
- Urinary Bladder Neoplasms/genetics
- Urinary Bladder Neoplasms/pathology
- Urinary Bladder Neoplasms/therapy
- Urinary Bladder Neoplasms/urine
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Affiliation(s)
- Naheema S Gordon
- Bladder Cancer Research Centre, Institute of Cancer & Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Laura A Baxter
- Department of Computer Science, University of Warwick, Coventry, UK
| | - Anshita Goel
- Bladder Cancer Research Centre, Institute of Cancer & Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Roland Arnold
- Bladder Cancer Research Centre, Institute of Cancer & Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Baljit Kaur
- Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Wenyu Liu
- Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Sarah J Pirrie
- Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Syed Hussain
- Department of Oncology and Metabolism, The Medical School, Sheffield, UK
| | - Richard Viney
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Daniel Ford
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Anjali Zarkar
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | | | - Timur Mitin
- Department of Radiation Medicine, Oregon Health and Science University, Portland, OR, USA
| | - Reid F Thompson
- Department of Radiation Medicine, Oregon Health and Science University, Portland, OR, USA
| | | | - Douglas G Ward
- Bladder Cancer Research Centre, Institute of Cancer & Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Richard T Bryan
- Bladder Cancer Research Centre, Institute of Cancer & Genomic Sciences, University of Birmingham, Birmingham, UK
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11
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Wan S, Liu X, Hua W, Xi M, Zhou Y, Wan Y. The role of telomerase reverse transcriptase (TERT) promoter mutations in prognosis in bladder cancer. Bioengineered 2021; 12:1495-1504. [PMID: 33938397 PMCID: PMC8806350 DOI: 10.1080/21655979.2021.1915725] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/07/2021] [Accepted: 04/07/2021] [Indexed: 01/12/2023] Open
Abstract
Telomerase reverse transcriptase (TERT) promoter mutations have been recognized as a common genetic event in bladder cancer (BC). Many studies have found the high TERT promoter mutations' prevalence in BC recurrence patients which may make the TERT promoter mutations become a potential prognosis prediction of BC. We performed a systematic search in Embase, PubMed, and Web of Science in January 2021. The aspects of evaluation, methods, validation, and results were used to evaluate the included studies' quality. We reviewed two of the most common mutations in types of TC, C288T and C250T and their relationship with prognosis of BC. Eight studies contained 1382 cases were enrolled in our study. The percentage of TERT promoter mutations in these cases was 62.5%. A statistically significant association was detected between TERT promoter mutation and recurrence (HR: 2.03, 95% CI: 1.53-2.68, p < 0.001). However, TERT promoter mutation was not significant associated with overall survival (HR: 1.077, 95% CI: 0.674-1.718, p = 0.757). No significant heterogeneities were observed (I2 = 47.5%, P = 0.064; I2 = 58.7%, p = 0.120, respectively). Bladder cancer patients with TERT promoter mutations take a higher risk of recurrence. TERT promoter mutations may become a potential prediction factor for bladder cancer recurrence.
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Affiliation(s)
- Song Wan
- Department of Urology, Huadu District People’s Hospital of Guangzhou, Guangzhou, China
| | - Xuan Liu
- Department of Urology, Huadu District People’s Hospital of Guangzhou, Guangzhou, China
| | - Wei Hua
- Department of Urology, Huadu District People’s Hospital of Guangzhou, Guangzhou, China
| | - Ming Xi
- Department of Urology, Huadu District People’s Hospital of Guangzhou, Guangzhou, China
| | - Yulin Zhou
- Department of Urology, Huadu District People’s Hospital of Guangzhou, Guangzhou, China
| | - Yueping Wan
- Department of Urology, Huadu District People’s Hospital of Guangzhou, Guangzhou, China
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12
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Olmedillas-López S, Olivera-Salazar R, García-Arranz M, García-Olmo D. Current and Emerging Applications of Droplet Digital PCR in Oncology: An Updated Review. Mol Diagn Ther 2021; 26:61-87. [PMID: 34773243 DOI: 10.1007/s40291-021-00562-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2021] [Indexed: 12/14/2022]
Abstract
In the era of personalized medicine and targeted therapies for the management of patients with cancer, ultrasensitive detection methods for tumor genotyping, such as next-generation sequencing or droplet digital polymerase chain reaction (ddPCR), play a significant role. In the search for less invasive strategies for diagnosis, prognosis and disease monitoring, the number of publications regarding liquid biopsy approaches using ddPCR has increased substantially in recent years. There is a long list of malignancies in which ddPCR provides a reliable and accurate tool for detection of nucleic acid-based markers derived from cell-free DNA, cell-free RNA, circulating tumor cells, extracellular vesicles or exosomes when isolated from whole blood, plasma and serum, helping to anticipate tumor relapse or unveil intratumor heterogeneity and clonal evolution in response to treatment. This updated review describes recent developments in ddPCR platforms and provides a general overview about the major applications of liquid biopsy in blood, including its utility for molecular response and minimal residual disease monitoring in hematological malignancies or the therapeutic management of patients with colorectal or lung cancer, particularly for the selection and monitoring of treatment with tyrosine kinase inhibitors. Although plasma is the main source of genetic material for tumor genomic profiling, liquid biopsy by ddPCR is being investigated in a wide variety of biologic fluids, such as cerebrospinal fluid, urine, stool, ocular fluids, sputum, saliva, bronchoalveolar lavage, pleural effusion, mucin, peritoneal fluid, fine needle aspirate, bile or pancreatic juice. The present review focuses on these "alternative" sources of genetic material and their analysis by ddPCR in different kinds of cancers.
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Affiliation(s)
- Susana Olmedillas-López
- New Therapies Laboratory, Health Research Institute-Fundación Jiménez Díaz University Hospital (IIS-FJD), Avda. Reyes Católicos, 2, 28040, Madrid, Spain.
| | - Rocío Olivera-Salazar
- New Therapies Laboratory, Health Research Institute-Fundación Jiménez Díaz University Hospital (IIS-FJD), Avda. Reyes Católicos, 2, 28040, Madrid, Spain
| | - Mariano García-Arranz
- New Therapies Laboratory, Health Research Institute-Fundación Jiménez Díaz University Hospital (IIS-FJD), Avda. Reyes Católicos, 2, 28040, Madrid, Spain.,Department of Surgery, School of Medicine, Universidad Autónoma de Madrid (UAM), 28029, Madrid, Spain
| | - Damián García-Olmo
- New Therapies Laboratory, Health Research Institute-Fundación Jiménez Díaz University Hospital (IIS-FJD), Avda. Reyes Católicos, 2, 28040, Madrid, Spain.,Department of Surgery, School of Medicine, Universidad Autónoma de Madrid (UAM), 28029, Madrid, Spain.,Department of Surgery, Fundación Jiménez Díaz University Hospital (FJD), 28040, Madrid, Spain
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13
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Jain M, Kamalov D, Tivtikyan A, Balatsky A, Samokhodskaya L, Okhobotov D, Kozlova P, Pisarev E, Zvereva M, Kamalov A. Urine TERT promoter mutations-based tumor DNA detection in patients with bladder cancer: A pilot study. Mol Clin Oncol 2021; 15:253. [PMID: 34712485 PMCID: PMC8548999 DOI: 10.3892/mco.2021.2415] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 07/09/2021] [Indexed: 12/20/2022] Open
Abstract
Telomerase reverse transcriptase (TERT) promoter mutations are the most frequent genetic events in bladder cancer (BC). The aim of the present pilot study was to evaluate the diagnostic potential of urine TERT promoter mutations-based liquid biopsy in patients with an ongoing oncological process, as well as in post-resection patients at risk of BC recurrence. A total of 60 patients were enrolled, of whom 27 patients had histologically proven BC; 23 had no signs of BC (control group); and 10 patients underwent transurethral malignancy resection 3-6 months prior to urine donation ('second look' group). Urine TERT promoter mutations were detected using Droplet Digital PCR. Receiver operating characteristic curve analysis revealed significant diagnostic power of the present approach (area under the curve: -0.768). At the cut-off value of tumor DNA fraction 0.34%, the sensitivity and specificity were 55.56 and 100%, respectively. In the positive samples, tumor DNA fraction varied significantly from 0.59 to 48.77%. In the 'second look' group, tumor DNA was detected in 4/10 patients, highlighting the possibility of BC recurrence with its fraction ranging only from 0.90 to 6.61%. Therefore, urine TERT promoter mutations-based liquid biopsy appears to be a promising tool for BC diagnosis and surveillance. The main study will include recruitment of additional patients, extension of the mutation panel, prolonged follow-up of the post-resection patients, as well as screening of industrial workers exposed to specific carcinogens.
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Affiliation(s)
- Mark Jain
- Medical Research and Educational Center, Lomonosov Moscow State University, 119992 Moscow, Russia
| | - David Kamalov
- Medical Research and Educational Center, Lomonosov Moscow State University, 119992 Moscow, Russia
| | - Alexander Tivtikyan
- Medical Research and Educational Center, Lomonosov Moscow State University, 119992 Moscow, Russia
| | - Alexander Balatsky
- Medical Research and Educational Center, Lomonosov Moscow State University, 119992 Moscow, Russia
| | - Larisa Samokhodskaya
- Medical Research and Educational Center, Lomonosov Moscow State University, 119992 Moscow, Russia
| | - Dmitry Okhobotov
- Medical Research and Educational Center, Lomonosov Moscow State University, 119992 Moscow, Russia
| | - Polina Kozlova
- Department of Fundamental Medicine, Lomonosov Moscow State University, 119991 Moscow, Russia
| | - Eduard Pisarev
- Department of Bioinformatics and Bioengineering, Lomonosov Moscow State University, 119991 Moscow, Russia
| | - Maria Zvereva
- Department of Chemistry, Lomonosov Moscow State University, 119991 Moscow, Russia
| | - Armais Kamalov
- Medical Research and Educational Center, Lomonosov Moscow State University, 119992 Moscow, Russia
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14
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Hayashi Y, Fujita K, Netto GJ, Nonomura N. Clinical Application of TERT Promoter Mutations in Urothelial Carcinoma. Front Oncol 2021; 11:705440. [PMID: 34395278 PMCID: PMC8358429 DOI: 10.3389/fonc.2021.705440] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 07/02/2021] [Indexed: 12/03/2022] Open
Abstract
Urothelial carcinoma (UC) is a common urological malignancy with a high rate of disease recurrence. Telomerase activity, a hallmark of cancer characterized by overcoming the replicative senescence, is upregulated in over 90% of patients with UC. Somatic mutations in the promoter region of telomerase reverse transcriptase (TERT) are frequently detected in UC, and drive telomerase activity. Recent studies have demonstrated a strong association between TERT promoter mutation and tumorigenesis of UC. Also, TERT promoter mutation has great potential for diagnosis, as well as prognosis in UC treatment, and this is also applicable for the liquid biopsy techniques. In this review, we discuss the progress in these areas and highlight the challenges, clinical potential, and future direction for developing UC treatment methods.
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Affiliation(s)
- Yujiro Hayashi
- Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan.,Department of Urology, Osaka General Medical Center, Osaka, Japan
| | - Kazutoshi Fujita
- Department of Urology, Kindai University Faculty of Medicine, Osakasayama, Japan
| | - George J Netto
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Norio Nonomura
- Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan
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15
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Hayashi Y, Fujita K. Toward urinary cell-free DNA-based treatment of urothelial carcinoma: a narrative review. Transl Androl Urol 2021; 10:1865-1877. [PMID: 33968675 PMCID: PMC8100839 DOI: 10.21037/tau-20-1259] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Liquid biopsy technique targeting urinary cell-free DNA (cfDNA) is getting a lot of attention to overcome limitations of the present treatment strategy for urothelial carcinoma, including urothelial bladder carcinoma (UBC) and upper tract urothelial carcinoma (UTUC). Analysis of tumor-derived DNA in urine focusing either on genomic or epigenomic alterations, holds great potential as a noninvasive method for the detection of urothelial carcinoma with high accuracy. It is also predictive of prognosis and response to drugs, and reveals the underlying characteristics of different stages of urothelial carcinoma. Although cfDNA methylation analyses based on a combination of several methylation profiles have demonstrated high sensitivity for UBC diagnosis, there have been few reports involving epigenomic studies of urinary cfDNA. In mutational analyses, frequent gene mutations (TERT promoter, TP53, FGFR3, PIK3CA, RAS, etc.) have been detected in urine supernatant by using remarkable technological innovations such as next-generation sequencing and droplet digital PCR. These methods allow highly sensitive detection of rare mutation alleles while minimizing artifacts. In this review, we summarize the current insights into the clinical applications of urinary cfDNA from patients with urothelial carcinoma. Although it is necessary to conduct prospective multi-institutional clinical trials, noninvasive urine biopsy is expected to play an important role in the realization of precision medicine in patients with urothelial carcinoma in the near future.
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Affiliation(s)
- Yujiro Hayashi
- Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Kazutoshi Fujita
- Department of Urology, Kindai University Faculty of Medicine, Osakasayama, Japan
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16
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Abarna R, Nancy R, Chacko A, Chacko G, Pai R. Diagnostic utility of droplet digital PCR to detect TERT promoter mutations among glioblastoma samples using 7-deaza-dGTP. J Clin Pathol 2021; 75:140-142. [PMID: 33766956 DOI: 10.1136/jclinpath-2021-207402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 02/18/2021] [Accepted: 03/01/2021] [Indexed: 11/03/2022]
Affiliation(s)
- Rajadurai Abarna
- Pathology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Rachel Nancy
- Pathology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Ari Chacko
- Division of Neurosciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Geeta Chacko
- Pathology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Rekha Pai
- Pathology, Christian Medical College, Vellore, Tamil Nadu, India
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17
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Herranz R, Oto J, Plana E, Fernández-Pardo Á, Cana F, Martínez-Sarmiento M, Vera-Donoso CD, España F, Medina P. Circulating Cell-Free DNA in Liquid Biopsies as Potential Biomarker for Bladder Cancer: A Systematic Review. Cancers (Basel) 2021; 13:1448. [PMID: 33810039 PMCID: PMC8005001 DOI: 10.3390/cancers13061448] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 03/03/2021] [Accepted: 03/16/2021] [Indexed: 12/24/2022] Open
Abstract
Bladder cancer (BC) is among the most frequent cancer types in the world and is the most lethal urological malignancy. Presently, diagnostic and follow-up methods for BC are expensive and invasive. Thus, the identification of novel predictive biomarkers for diagnosis, progression, and prognosis of BC is of paramount importance. To date, several studies have evidenced that cell-free DNA (cfDNA) found in liquid biopsies such as blood and urine may play a role in the particular scenario of urologic tumors, and its analysis may improve BC diagnosis report about cancer progression or even evaluate the effectiveness of a specific treatment or anticipate whether a treatment would be useful for a specific patient depending on the tumor characteristics. In the present review, we have summarized the up-to-date studies evaluating the value of cfDNA as potential diagnostic, prognostic, or monitoring biomarker for BC in several biofluids.
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Affiliation(s)
- Raquel Herranz
- Haemostasis, Thrombosis, Arteriosclerosis and Vascular Biology Research Group, Medical Research Institute Hospital La Fe, Avenida Fernando Abril Martorell 106, 46026 Valencia, Spain; (R.H.); (J.O.); (E.P.); (Á.F.-P.); (F.C.); (F.E.)
| | - Julia Oto
- Haemostasis, Thrombosis, Arteriosclerosis and Vascular Biology Research Group, Medical Research Institute Hospital La Fe, Avenida Fernando Abril Martorell 106, 46026 Valencia, Spain; (R.H.); (J.O.); (E.P.); (Á.F.-P.); (F.C.); (F.E.)
| | - Emma Plana
- Haemostasis, Thrombosis, Arteriosclerosis and Vascular Biology Research Group, Medical Research Institute Hospital La Fe, Avenida Fernando Abril Martorell 106, 46026 Valencia, Spain; (R.H.); (J.O.); (E.P.); (Á.F.-P.); (F.C.); (F.E.)
- Angiology and Vascular Surgery Service, La Fe University and Polytechnic Hospital, Avenida Fernando Abril Martorell 106, 46026 Valencia, Spain
| | - Álvaro Fernández-Pardo
- Haemostasis, Thrombosis, Arteriosclerosis and Vascular Biology Research Group, Medical Research Institute Hospital La Fe, Avenida Fernando Abril Martorell 106, 46026 Valencia, Spain; (R.H.); (J.O.); (E.P.); (Á.F.-P.); (F.C.); (F.E.)
| | - Fernando Cana
- Haemostasis, Thrombosis, Arteriosclerosis and Vascular Biology Research Group, Medical Research Institute Hospital La Fe, Avenida Fernando Abril Martorell 106, 46026 Valencia, Spain; (R.H.); (J.O.); (E.P.); (Á.F.-P.); (F.C.); (F.E.)
| | - Manuel Martínez-Sarmiento
- Department of Urology, La Fe University and Polytechnic Hospital, Avenida Fernando Abril Martorell 106, 46026 Valencia, Spain; (M.M.-S.); (C.D.V.-D.)
| | - César D. Vera-Donoso
- Department of Urology, La Fe University and Polytechnic Hospital, Avenida Fernando Abril Martorell 106, 46026 Valencia, Spain; (M.M.-S.); (C.D.V.-D.)
| | - Francisco España
- Haemostasis, Thrombosis, Arteriosclerosis and Vascular Biology Research Group, Medical Research Institute Hospital La Fe, Avenida Fernando Abril Martorell 106, 46026 Valencia, Spain; (R.H.); (J.O.); (E.P.); (Á.F.-P.); (F.C.); (F.E.)
| | - Pilar Medina
- Haemostasis, Thrombosis, Arteriosclerosis and Vascular Biology Research Group, Medical Research Institute Hospital La Fe, Avenida Fernando Abril Martorell 106, 46026 Valencia, Spain; (R.H.); (J.O.); (E.P.); (Á.F.-P.); (F.C.); (F.E.)
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18
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Tran L, Xiao JF, Agarwal N, Duex JE, Theodorescu D. Advances in bladder cancer biology and therapy. Nat Rev Cancer 2021; 21:104-121. [PMID: 33268841 PMCID: PMC10112195 DOI: 10.1038/s41568-020-00313-1] [Citation(s) in RCA: 305] [Impact Index Per Article: 101.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/21/2020] [Indexed: 12/26/2022]
Abstract
The field of research in bladder cancer has seen significant advances in recent years. Next-generation sequencing has identified the genes most mutated in bladder cancer. This wealth of information allowed the definition of driver mutations, and identification of actionable therapeutic targets, as well as a clearer picture of patient prognosis and therapeutic direction. In a similar vein, our understanding of the cellular aspects of bladder cancer has grown. The identification of the cellular geography and the populations of different cell types and quantifications of normal and abnormal cell types in tumours provide a better prediction of therapeutic response. Non-invasive methods of diagnosis, including liquid biopsies, have seen major advances as well. These methods will likely find considerable utility in assessing minimal residual disease following treatment and for early-stage diagnosis. A significant therapeutic impact on patients with bladder cancer is found in the use of immune checkpoint inhibitor therapeutics. These therapeutics have been shown to cure some patients with bladder cancer and significantly decrease adverse events. These developments provide patients with better monitoring opportunities, unique therapeutic options and greater hope for prolonged survival.
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Affiliation(s)
- Linda Tran
- Department of Surgery (Urology), Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Cedars-Sinai Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA, USA
| | - Jin-Fen Xiao
- Department of Surgery (Urology), Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Cedars-Sinai Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA, USA
| | - Neeraj Agarwal
- Cedars-Sinai Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA, USA
- Department of Medicine (Hematology/Oncology), Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Jason E Duex
- Cedars-Sinai Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA, USA
| | - Dan Theodorescu
- Department of Surgery (Urology), Cedars-Sinai Medical Center, Los Angeles, CA, USA.
- Cedars-Sinai Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA, USA.
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
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19
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Huang H, Li H. Tumor heterogeneity and the potential role of liquid biopsy in bladder cancer. Cancer Commun (Lond) 2020; 41:91-108. [PMID: 33377623 PMCID: PMC7896752 DOI: 10.1002/cac2.12129] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 10/28/2020] [Accepted: 12/23/2020] [Indexed: 12/24/2022] Open
Abstract
Bladder cancer (BC) is a heterogeneous disease that characterized by genomic instability and a high mutation rate. Heterogeneity in tumor may partially explain the diversity of responses to targeted therapies and the various clinical outcomes. A combination of cytology and cystoscopy is the standard methodology for BC diagnosis, prognosis, and disease surveillance. However, genomics analyses of single tumor‐biopsy specimens may underestimate the mutational burden of heterogeneous tumors. Liquid biopsy, as a promising technology, enables analysis of tumor components in the bodily fluids, such as blood and urine, at multiple time points and provides a minimally invasive approach that can track the evolutionary dynamics and monitor tumor heterogeneity. In this review, we describe the multiple faces of BC heterogeneity at the genomic and transcriptional levels and how they affect clinical care and outcomes. We also summarize the outcomes of liquid biopsy in BC, which plays a potential role in revealing tumor heterogeneity. Finally, we discuss the challenges that must be addressed before liquid biopsy can be widely used in clinical treatment.
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Affiliation(s)
- Hai‐Ming Huang
- Department of Clinical LaboratoryPeking University First HospitalBeijing100034P. R. China
| | - Hai‐Xia Li
- Department of Clinical LaboratoryPeking University First HospitalBeijing100034P. R. China
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20
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Hosen MI, Forey N, Durand G, Voegele C, Bilici S, Avogbe PH, Delhomme TM, Foll M, Manel A, Vian E, Meziani S, De Tilly B, Polo G, Lole O, Francois P, Boureille A, Pisarev E, Salas AROSE, Monteiro-Reis S, Henrique R, Byrnes G, Jeronimo C, Scelo G, McKay JD, Calvez-Kelm FL, Zvereva M. Development of Sensitive Droplet Digital PCR Assays for Detecting Urinary TERT Promoter Mutations as Non-Invasive Biomarkers for Detection of Urothelial Cancer. Cancers (Basel) 2020; 12:E3541. [PMID: 33260905 PMCID: PMC7761513 DOI: 10.3390/cancers12123541] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 11/18/2020] [Accepted: 11/23/2020] [Indexed: 12/24/2022] Open
Abstract
Somatic mutations in the telomerase reverse transcriptase (TERT) promoter regions are frequent events in urothelial cancer (UC) and their detection in urine (supernatant cell-free DNA or DNA from exfoliated cells) could serve as putative non-invasive biomarkers for UC detection and monitoring. However, detecting these tumor-borne mutations in urine requires highly sensitive methods, capable of measuring low-level mutations. In this study, we developed sensitive droplet digital PCR (ddPCR) assays for detecting TERT promoter mutations (C228T, C228A, CC242-243TT, and C250T). We tested the C228T and C250T ddPCR assays on all samples with sufficient quantity of urinary DNA (urine supernatant cell-free DNA (US cfDNA) or urine pellet cellular DNA (UP cellDNA)) from the DIAGURO (n = 89/93 cases and n = 92/94 controls) and from the IPO-PORTO (n = 49/50 cases and n = 50/50 controls) series that were previously screened with the UroMuTERT assay and compared the performance of the two approaches. In the DIAGURO series, the sensitivity and specificity of the ddPCR assays for detecting UC using either US cfDNA or UP cellDNA were 86.8% and 92.4%. The sensitivity was slightly higher than that of the UroMuTERT assay in the IPO-PORTO series (67.4% vs. 65.3%, respectively), but not in the DIAGURO series (86.8% vs. 90.7%). The specificity was 100% in the IPO-PORTO controls for both the UroMuTERT and ddPCR assays, whereas in the DIAGURO series, the specificity dropped for ddPCR (92.4% versus 95.6%). Overall, an almost perfect agreement between the two methods was observed for both US cfDNA (n = 164; kappa coefficient of 0.91) and UP cellDNA (n = 280; kappa coefficient of 0.94). In a large independent series of serial urine samples from DIAGURO follow-up BC cases (n = 394), the agreement between ddPCR and UroMuTERT was (i) strong (kappa coefficient of 0.87), regardless of urine DNA types (kappa coefficient 0.89 for US cfDNA and 0.85 for UP cellDNA), (ii) the highest for samples with mutant allelic fractions (MAFs) > 2% (kappa coefficient of 0.99) and (iii) only minimal for the samples with the lowest MAFs (< 0.5%; kappa coefficient 0.32). Altogether, our results indicate that the two methods (ddPCR and UroMuTERT) for detecting urinary TERT promoter mutations are comparable and that the discrepancies relate to the detection of low-allelic fraction mutations. The simplicity of the ddPCR assays makes them suitable for implementation in clinical settings.
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Affiliation(s)
- Md Ismail Hosen
- International Agency for Research on Cancer (IARC), 69372 Lyon, France; (M.I.H.); (N.F.); (G.D.); (C.V.); (S.B.); (P.H.A.); (T.M.D.); (M.F.); (S.M.); (O.L.); (P.F.); (A.B.); (A.R.O.S.E.S.); (G.B.); (G.S.); (J.D.M.)
- Department of Biochemistry and Molecular Biology, Faculty of Biological Sciences, University of Dhaka, Dhaka 1000, Bangladesh
| | - Nathalie Forey
- International Agency for Research on Cancer (IARC), 69372 Lyon, France; (M.I.H.); (N.F.); (G.D.); (C.V.); (S.B.); (P.H.A.); (T.M.D.); (M.F.); (S.M.); (O.L.); (P.F.); (A.B.); (A.R.O.S.E.S.); (G.B.); (G.S.); (J.D.M.)
| | - Geoffroy Durand
- International Agency for Research on Cancer (IARC), 69372 Lyon, France; (M.I.H.); (N.F.); (G.D.); (C.V.); (S.B.); (P.H.A.); (T.M.D.); (M.F.); (S.M.); (O.L.); (P.F.); (A.B.); (A.R.O.S.E.S.); (G.B.); (G.S.); (J.D.M.)
| | - Catherine Voegele
- International Agency for Research on Cancer (IARC), 69372 Lyon, France; (M.I.H.); (N.F.); (G.D.); (C.V.); (S.B.); (P.H.A.); (T.M.D.); (M.F.); (S.M.); (O.L.); (P.F.); (A.B.); (A.R.O.S.E.S.); (G.B.); (G.S.); (J.D.M.)
| | - Selin Bilici
- International Agency for Research on Cancer (IARC), 69372 Lyon, France; (M.I.H.); (N.F.); (G.D.); (C.V.); (S.B.); (P.H.A.); (T.M.D.); (M.F.); (S.M.); (O.L.); (P.F.); (A.B.); (A.R.O.S.E.S.); (G.B.); (G.S.); (J.D.M.)
| | - Patrice Hodonou Avogbe
- International Agency for Research on Cancer (IARC), 69372 Lyon, France; (M.I.H.); (N.F.); (G.D.); (C.V.); (S.B.); (P.H.A.); (T.M.D.); (M.F.); (S.M.); (O.L.); (P.F.); (A.B.); (A.R.O.S.E.S.); (G.B.); (G.S.); (J.D.M.)
| | - Tiffany Myriam Delhomme
- International Agency for Research on Cancer (IARC), 69372 Lyon, France; (M.I.H.); (N.F.); (G.D.); (C.V.); (S.B.); (P.H.A.); (T.M.D.); (M.F.); (S.M.); (O.L.); (P.F.); (A.B.); (A.R.O.S.E.S.); (G.B.); (G.S.); (J.D.M.)
| | - Matthieu Foll
- International Agency for Research on Cancer (IARC), 69372 Lyon, France; (M.I.H.); (N.F.); (G.D.); (C.V.); (S.B.); (P.H.A.); (T.M.D.); (M.F.); (S.M.); (O.L.); (P.F.); (A.B.); (A.R.O.S.E.S.); (G.B.); (G.S.); (J.D.M.)
| | | | - Emmanuel Vian
- Department of Urology, Protestant Clinic of Lyon, 69300 Caluire-et-Cuire, France; (E.V.); (B.D.T.); (G.P.)
| | - Sonia Meziani
- International Agency for Research on Cancer (IARC), 69372 Lyon, France; (M.I.H.); (N.F.); (G.D.); (C.V.); (S.B.); (P.H.A.); (T.M.D.); (M.F.); (S.M.); (O.L.); (P.F.); (A.B.); (A.R.O.S.E.S.); (G.B.); (G.S.); (J.D.M.)
| | - Berengere De Tilly
- Department of Urology, Protestant Clinic of Lyon, 69300 Caluire-et-Cuire, France; (E.V.); (B.D.T.); (G.P.)
| | - Gilles Polo
- Department of Urology, Protestant Clinic of Lyon, 69300 Caluire-et-Cuire, France; (E.V.); (B.D.T.); (G.P.)
| | - Olesia Lole
- International Agency for Research on Cancer (IARC), 69372 Lyon, France; (M.I.H.); (N.F.); (G.D.); (C.V.); (S.B.); (P.H.A.); (T.M.D.); (M.F.); (S.M.); (O.L.); (P.F.); (A.B.); (A.R.O.S.E.S.); (G.B.); (G.S.); (J.D.M.)
| | - Pauline Francois
- International Agency for Research on Cancer (IARC), 69372 Lyon, France; (M.I.H.); (N.F.); (G.D.); (C.V.); (S.B.); (P.H.A.); (T.M.D.); (M.F.); (S.M.); (O.L.); (P.F.); (A.B.); (A.R.O.S.E.S.); (G.B.); (G.S.); (J.D.M.)
| | - Antoine Boureille
- International Agency for Research on Cancer (IARC), 69372 Lyon, France; (M.I.H.); (N.F.); (G.D.); (C.V.); (S.B.); (P.H.A.); (T.M.D.); (M.F.); (S.M.); (O.L.); (P.F.); (A.B.); (A.R.O.S.E.S.); (G.B.); (G.S.); (J.D.M.)
| | - Eduard Pisarev
- Faculty of Bioengineering and Bioinformatics, Lomonosov Moscow State University, 119234 Moscow, Russia;
| | - Andrei R. O. S. E. Salas
- International Agency for Research on Cancer (IARC), 69372 Lyon, France; (M.I.H.); (N.F.); (G.D.); (C.V.); (S.B.); (P.H.A.); (T.M.D.); (M.F.); (S.M.); (O.L.); (P.F.); (A.B.); (A.R.O.S.E.S.); (G.B.); (G.S.); (J.D.M.)
- Santa Casa de Sao Paulo School of Medical Sciences, Sao Paulo 01221-020, Brazil
| | - Sara Monteiro-Reis
- Portuguese Oncology Institute of Porto, Research Center (CI-IPOP), 4200-072 Porto, Portugal; (S.M.-R.); (R.H.); (C.J.)
| | - Rui Henrique
- Portuguese Oncology Institute of Porto, Research Center (CI-IPOP), 4200-072 Porto, Portugal; (S.M.-R.); (R.H.); (C.J.)
- Department of Pathology, Portuguese Oncology Institute of Porto (IPOP), 4200-072 Porto, Portugal
- Institute of Biomedical Sciences Abel Salazar, University of Porto (ICBAS-UP), 4099-002 Porto, Portugal
| | - Graham Byrnes
- International Agency for Research on Cancer (IARC), 69372 Lyon, France; (M.I.H.); (N.F.); (G.D.); (C.V.); (S.B.); (P.H.A.); (T.M.D.); (M.F.); (S.M.); (O.L.); (P.F.); (A.B.); (A.R.O.S.E.S.); (G.B.); (G.S.); (J.D.M.)
| | - Carmen Jeronimo
- Portuguese Oncology Institute of Porto, Research Center (CI-IPOP), 4200-072 Porto, Portugal; (S.M.-R.); (R.H.); (C.J.)
- Department of Pathology, Portuguese Oncology Institute of Porto (IPOP), 4200-072 Porto, Portugal
- Institute of Biomedical Sciences Abel Salazar, University of Porto (ICBAS-UP), 4099-002 Porto, Portugal
| | - Ghislaine Scelo
- International Agency for Research on Cancer (IARC), 69372 Lyon, France; (M.I.H.); (N.F.); (G.D.); (C.V.); (S.B.); (P.H.A.); (T.M.D.); (M.F.); (S.M.); (O.L.); (P.F.); (A.B.); (A.R.O.S.E.S.); (G.B.); (G.S.); (J.D.M.)
- Department of Medical Sciences, University of Turin, 8-10124 Turin, Italy
| | - James D. McKay
- International Agency for Research on Cancer (IARC), 69372 Lyon, France; (M.I.H.); (N.F.); (G.D.); (C.V.); (S.B.); (P.H.A.); (T.M.D.); (M.F.); (S.M.); (O.L.); (P.F.); (A.B.); (A.R.O.S.E.S.); (G.B.); (G.S.); (J.D.M.)
| | - Florence Le Calvez-Kelm
- International Agency for Research on Cancer (IARC), 69372 Lyon, France; (M.I.H.); (N.F.); (G.D.); (C.V.); (S.B.); (P.H.A.); (T.M.D.); (M.F.); (S.M.); (O.L.); (P.F.); (A.B.); (A.R.O.S.E.S.); (G.B.); (G.S.); (J.D.M.)
| | - Maria Zvereva
- International Agency for Research on Cancer (IARC), 69372 Lyon, France; (M.I.H.); (N.F.); (G.D.); (C.V.); (S.B.); (P.H.A.); (T.M.D.); (M.F.); (S.M.); (O.L.); (P.F.); (A.B.); (A.R.O.S.E.S.); (G.B.); (G.S.); (J.D.M.)
- Department of Chemistry, Lomonosov Moscow State University, 119991 Moscow, Russia
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21
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Pritchard JJG, Hamilton G, Hurst CD, Fraser S, Orange C, Knowles MA, Jones RJ, Leung HY, Iwata T. Monitoring of urothelial cancer disease status after treatment by digital droplet PCR liquid biopsy assays. Urol Oncol 2020; 38:737.e1-737.e10. [PMID: 32532529 DOI: 10.1016/j.urolonc.2020.05.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 04/12/2020] [Accepted: 05/10/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Real-time monitoring of disease status would be beneficial for timely decision making in the treatment of urothelial cancer (UC), and may accelerate the evaluation of clinical trials. Use of cell free tumor DNA (cftDNA) as a biomarker in liquid biopsy is minimally invasive and its successful use has been reported in various cancer types, including UC. The objective of this study was to evaluate the use of digital droplet PCR (ddPCR)-based assays to monitor UC after treatment. METHOD AND MATERIALS Blood, urine and matching formalin fixed, paraffin embedded diagnostic specimens were collected from 20 patients diagnosed with stage T1 (n = 2) and T2/T3 (n = 18) disease. SNaPshot assays, Sanger sequencing and whole exome sequencing were used to identify tumor-specific mutations, and somatic mutation status was confirmed using patient-matched DNAs extracted from buffy coats and peripheral blood mononucleocytes. The ddPCR assays of the tumor-specific mutations were used to detect the fractional abundance of cftDNA in plasma and urine. RESULTS SNaPshot and Sanger sequencing identified point mutations in 70% of the patients that were assayable by ddPCR. Cases of remission and relapse monitored by assays for PIK3CA E542K and TP53 Y163C mutations in plasma and urine concurred with clinical observations up to 48 months from the start of chemotherapy. A new ddPCR assay for the telomerase reverse transcriptase (TERT) promoter (-124) mutation was developed. The TERT assay was able to detect mutations in cases below the limit of detection by SNaPshot. Whole exome sequencing identified a novel mutation, CNTNAP4 G727*. A ddPCR assay designed to detect this mutation was able to distinguish mutant from wild-type alleles. CONCLUSIONS The study demonstrated that ddPCR assays could be used to detect cftDNA in liquid biopsy monitoring of the post-therapy disease status in patients with UC. Overall, 70% of the patients in our study harbored mutations that were assayable by ddPCR.
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Affiliation(s)
- John J G Pritchard
- School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Graham Hamilton
- Glasgow Polyomics, University of Glasgow, Glasgow, United Kingdom
| | - Carolyn D Hurst
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, United Kingdom
| | - Sioban Fraser
- Department of Pathology, Queen Elizabeth University Hospital, Glasgow, United Kingdom
| | - Clare Orange
- Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Margaret A Knowles
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, United Kingdom
| | - Robert J Jones
- Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom; Cancer Research UK Beatson Institute, Glasgow, United Kingdom; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom
| | - Hing Y Leung
- Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom; Cancer Research UK Beatson Institute, Glasgow, United Kingdom
| | - Tomoko Iwata
- School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom.
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22
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Liskova A, Samec M, Koklesova L, Giordano FA, Kubatka P, Golubnitschaja O. Liquid Biopsy is Instrumental for 3PM Dimensional Solutions in Cancer Management. J Clin Med 2020; 9:E2749. [PMID: 32854390 PMCID: PMC7563444 DOI: 10.3390/jcm9092749] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 08/17/2020] [Accepted: 08/20/2020] [Indexed: 02/06/2023] Open
Abstract
One in every four deaths is due to cancer in Europe. In view of its increasing incidence, cancer became the leading cause of death and disease burden in Denmark, France, the Netherlands, and the UK. Without essential improvements in cancer prevention, an additional 775,000 cases of annual incidence have been prognosed until 2040. Between 1995 and 2018, the direct costs of cancer doubled from EUR 52 billion to EUR 103 billion in Europe, and per capita health spending on cancer increased by 86% from EUR 105 to EUR 195 in general, whereby Austria, Germany, Switzerland, Benelux, and France spend the most on cancer care compared to other European countries. In view of the consequent severe socio-economic burden on society, the paradigm change from a reactive to a predictive, preventive, and personalized medical approach in the overall cancer management is essential. Concepts of predictive, preventive, and personalized medicine (3PM) demonstrate a great potential to revise the above presented trends and to implement cost-effective healthcare that benefits the patient and society as a whole. At any stage, application of early and predictive diagnostics, targeted prevention, and personalization of medical services are basic pillars making 3PM particularly attractive for the patients as well as ethical and cost-effective healthcare. Optimal 3PM approach requires novel instruments such as well-designed liquid biopsy application. This review article highlights current achievements and details liquid biopsy approaches specifically in cancer management. 3PM-relevant expert recommendations are provided.
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Affiliation(s)
- Alena Liskova
- Department of Obstetrics and Gynecology, Jessenius Faculty of Medicine, Comenius University in Bratislava, 036 01 Martin, Slovakia; (A.L.); (M.S.); (L.K.)
| | - Marek Samec
- Department of Obstetrics and Gynecology, Jessenius Faculty of Medicine, Comenius University in Bratislava, 036 01 Martin, Slovakia; (A.L.); (M.S.); (L.K.)
| | - Lenka Koklesova
- Department of Obstetrics and Gynecology, Jessenius Faculty of Medicine, Comenius University in Bratislava, 036 01 Martin, Slovakia; (A.L.); (M.S.); (L.K.)
| | - Frank A. Giordano
- Department of Radiation Oncology, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, 53127 Bonn, Germany;
| | - Peter Kubatka
- Department of Medical Biology, Jessenius Faculty of Medicine, Comenius University in Bratislava, 036 01 Martin, Slovakia;
| | - Olga Golubnitschaja
- Predictive, Preventive and Personalised (3P) Medicine, Department of Radiation Oncology, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, 53127 Bonn, Germany
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23
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Zvereva M, Pisarev E, Hosen I, Kisil O, Matskeplishvili S, Kubareva E, Kamalov D, Tivtikyan A, Manel A, Vian E, Kamalov A, Ecke T, Calvez-Kelm FL. Activating Telomerase TERT Promoter Mutations and Their Application for the Detection of Bladder Cancer. Int J Mol Sci 2020; 21:E6034. [PMID: 32839402 PMCID: PMC7503716 DOI: 10.3390/ijms21176034] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 08/17/2020] [Accepted: 08/18/2020] [Indexed: 01/10/2023] Open
Abstract
This review summarizes state-of-the-art knowledge in early-generation and novel urine biomarkers targeting the telomerase pathway for the detection and follow-up of bladder cancer (BC). The limitations of the assays detecting telomerase reactivation are discussed and the potential of transcription-activating mutations in the promoter of the TERT gene detected in the urine as promising simple non-invasive BC biomarkers is highlighted. Studies have shown good sensitivity and specificity of the urinary TERT promoter mutations in case-control studies and, more recently, in a pilot prospective cohort study, where the marker was detected up to 10 years prior to clinical diagnosis. However, large prospective cohort studies and intervention studies are required to fully validate their robustness and assess their clinical utility. Furthermore, it may be interesting to evaluate whether the clinical performance of urinary TERT promoter mutations could increase when combined with other simple urinary biomarkers. Finally, different approaches for assessment of TERT promoter mutations in urine samples are presented together with technical challenges, thus highlighting the need of careful technological validation and standardization of laboratory methods prior to translation into clinical practice.
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Affiliation(s)
- Maria Zvereva
- Chair of Chemistry of Natural Compounds, Department of Chemistry, Lomonosov Moscow State University, 119991 Moscow, Russia
- International Agency for Research on Cancer (IARC), 69372 Lyon, France;
| | - Eduard Pisarev
- Faculty of Bioengineering and Bioinformatics, Lomonosov Moscow State University, 119234 Moscow, Russia;
| | - Ismail Hosen
- Department of Biochemistry and Molecular Biology, Faculty of Biological Sciences, University of Dhaka, Dhaka 1000, Bangladesh;
| | - Olga Kisil
- Gause Institute of New Antibiotics, 119021 Moscow, Russia;
| | - Simon Matskeplishvili
- Medical Research and Education Center, Lomonosov Moscow State University, 119992 Moscow, Russia; (S.M.); (D.K.); (A.T.); (A.K.)
| | - Elena Kubareva
- Belozersky Institute of Physico-Chemical Biology, Moscow State University, 119992 Moscow, Russia;
| | - David Kamalov
- Medical Research and Education Center, Lomonosov Moscow State University, 119992 Moscow, Russia; (S.M.); (D.K.); (A.T.); (A.K.)
| | - Alexander Tivtikyan
- Medical Research and Education Center, Lomonosov Moscow State University, 119992 Moscow, Russia; (S.M.); (D.K.); (A.T.); (A.K.)
| | | | - Emmanuel Vian
- Department of Urology, Protestant Clinic of Lyon, 69300 Lyon, France;
| | - Armais Kamalov
- Medical Research and Education Center, Lomonosov Moscow State University, 119992 Moscow, Russia; (S.M.); (D.K.); (A.T.); (A.K.)
| | - Thorsten Ecke
- Department of Urology, HELIOS Hospital Bad Saarow, D-15526 Bad Saarow, Germany;
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24
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Chaudhuri AA, Pellini B, Pejovic N, Chauhan PS, Harris PK, Szymanski JJ, Smith ZL, Arora VK. Emerging Roles of Urine-Based Tumor DNA Analysis in Bladder Cancer Management. JCO Precis Oncol 2020; 4:PO.20.00060. [PMID: 32923907 PMCID: PMC7448529 DOI: 10.1200/po.20.00060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2020] [Indexed: 12/26/2022] Open
Affiliation(s)
- Aadel A. Chaudhuri
- Division of Cancer Biology, Department of Radiation Oncology, Washington University School of Medicine, St Louis, MO
- Department of Genetics, Washington University School of Medicine, St Louis, MO
- Department of Computer Science and Engineering, Washington University in St Louis, St Louis, MO
- Department of Biomedical Engineering, Washington University in St Louis, St Louis, MO
- Siteman Cancer Center, Barnes Jewish Hospital and Washington University School of Medicine, St Louis, MO
| | - Bruna Pellini
- Siteman Cancer Center, Barnes Jewish Hospital and Washington University School of Medicine, St Louis, MO
- Division of Oncology, Department of Medicine, Washington University School of Medicine, St Louis, MO
| | - Nadja Pejovic
- Division of Cancer Biology, Department of Radiation Oncology, Washington University School of Medicine, St Louis, MO
| | - Pradeep S. Chauhan
- Division of Cancer Biology, Department of Radiation Oncology, Washington University School of Medicine, St Louis, MO
| | - Peter K. Harris
- Division of Cancer Biology, Department of Radiation Oncology, Washington University School of Medicine, St Louis, MO
| | - Jeffrey J. Szymanski
- Division of Cancer Biology, Department of Radiation Oncology, Washington University School of Medicine, St Louis, MO
- Siteman Cancer Center, Barnes Jewish Hospital and Washington University School of Medicine, St Louis, MO
| | - Zachary L. Smith
- Siteman Cancer Center, Barnes Jewish Hospital and Washington University School of Medicine, St Louis, MO
- Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, St Louis, MO
| | - Vivek K. Arora
- Siteman Cancer Center, Barnes Jewish Hospital and Washington University School of Medicine, St Louis, MO
- Division of Oncology, Department of Medicine, Washington University School of Medicine, St Louis, MO
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Lee EY, Lee EJ, Yoon H, Lee DH, Kim KH. Comparison of Four Commercial Kits for Isolation of Urinary Cell-Free DNA and Sample Storage Conditions. Diagnostics (Basel) 2020; 10:diagnostics10040234. [PMID: 32325682 PMCID: PMC7236016 DOI: 10.3390/diagnostics10040234] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 04/16/2020] [Accepted: 04/16/2020] [Indexed: 12/25/2022] Open
Abstract
Urinary cell-free DNA (cfDNA) is an attractive body fluid for liquid biopsy. In this study, we compared the efficiencies of four commercial kits for urinary cell-free DNA (cfDNA) isolation and of various sample storage conditions. Urinary cfDNA was isolated from 10 healthy individuals using four commercial kits: QIAamp Circulating Nucleic Acid Kit (QC; Qiagen), MagMAX™ Cell-Free DNA Isolation Kit (MM; Applied Biosystems), Urine Cell-Free Circulating DNA Purification Midi Kit (NU; Norgen Biotek), and Quick-DNA™ Urine Kit (ZQ; Zymo Research). To assess the isolation efficiency, an Agilent 2100 Bioanalyzer with High Sensitivity DNA chips was used, and cfDNA yield was defined as the amount of cfDNA obtained from 1 mL of urine. MM and QC provided the highest cfDNA yield in the 50–300 bp range, and MM and NU gave the highest cfDNA yield in the 50–100 bp range. In particular, the NU kit was efficient for isolation of more fragmented cfDNA in the range of 50–100 bp with the lowest cellular genomic DNA contamination. ZQ had the best cost-efficiency for isolating the same amount of urinary cfDNA. Samples stored at −70 °C with the addition of 10 mM EDTA resulted in the highest cfDNA yield 3 months after sample collection.
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Affiliation(s)
- Eun Young Lee
- Department of Urology, College of Medicine, Ewha Womans University, Seoul 07804, Korea; (E.Y.L.); (E.-J.L.); (H.Y.); (D.H.L.)
- Ewha Medical Research Institute, College of Medicine, Ewha Womans University, Seoul 07804, Korea
| | - Eun-Ju Lee
- Department of Urology, College of Medicine, Ewha Womans University, Seoul 07804, Korea; (E.Y.L.); (E.-J.L.); (H.Y.); (D.H.L.)
- Ewha Medical Research Institute, College of Medicine, Ewha Womans University, Seoul 07804, Korea
| | - Hana Yoon
- Department of Urology, College of Medicine, Ewha Womans University, Seoul 07804, Korea; (E.Y.L.); (E.-J.L.); (H.Y.); (D.H.L.)
| | - Dong Hyeon Lee
- Department of Urology, College of Medicine, Ewha Womans University, Seoul 07804, Korea; (E.Y.L.); (E.-J.L.); (H.Y.); (D.H.L.)
| | - Kwang Hyun Kim
- Department of Urology, College of Medicine, Ewha Womans University, Seoul 07804, Korea; (E.Y.L.); (E.-J.L.); (H.Y.); (D.H.L.)
- Correspondence: ; Tel.: +82-2-6986-1685; Fax: +82-2-6986-3258
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26
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Yang Z, Zhao S, Zhou J, Lei S, Hu Z. Erdheim-Chester disease: a case treated with IFN-α monitored using plasma and urine cell-free DNA. Immunotherapy 2020; 12:379-387. [PMID: 32290742 DOI: 10.2217/imt-2019-0150] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Erdheim-Chester disease is a rare form of non-Langerhans histiocytosis. A 40-year-old woman was diagnosed as Erdheim-Chester disease based on typical bone scintigraphy, symmetric osteosclerosis and findings of foamy, non-Langerhans histiocytes in bone marrow. BRAFV600E mutation was detected in a bone biopsy. Treatment with IFN-α showed significant improvement. The BRAFV600E mutant was detected in plasma cell-free DNA (cfDNA) by a droplet-digital PCR assay. Longitudinal analysis of BRAFV600E in plasma cfDNA showed a decreasing trend during treatment. We could not detect the mutant in urinary cfDNA. While, similar studies have detected the BRAFV600E mutant in urine, but not in plasma. A combination of allele burden assessments in plasma and urine may be helpful for detecting the residual mutant burden and monitoring therapeutic response.
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Affiliation(s)
- Zhi Yang
- Department of Nephrology and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu City, Sichuan Province, China, 610041
| | - Sha Zhao
- Department of Pathology, West China Hospital, Sichuan University, Chengdu City, Sichuan Province, China 610041
| | - Juan Zhou
- Department of Laboratory, West China Hospital, Sichuan University, Chengdu City, Sichuan Province, China, 610041
| | - Song Lei
- Department of Pathology, West China Hospital, Sichuan University, Chengdu City, Sichuan Province, China 610041
| | - Zhangxue Hu
- Department of Nephrology and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu City, Sichuan Province, China, 610041
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Roggisch J, Ecke T, Koch S. Molecular identification of telomerase reverse transcriptase (TERT) promotor mutations in primary and recurrent tumors of invasive and noninvasive urothelial bladder cancer. Urol Oncol 2020; 38:77.e17-77.e25. [DOI: 10.1016/j.urolonc.2019.08.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 08/09/2019] [Accepted: 08/14/2019] [Indexed: 11/26/2022]
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28
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Ou Z, Li K, Yang T, Dai Y, Chandra M, Ning J, Wang Y, Xu R, Gao T, Xie Y, He Q, Li Y, Lu Q, Wang L, Song Z. Detection of bladder cancer using urinary cell-free DNA and cellular DNA. Clin Transl Med 2020; 9:4. [PMID: 31938901 PMCID: PMC6960275 DOI: 10.1186/s40169-020-0257-2] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 01/05/2020] [Indexed: 01/29/2023] Open
Abstract
Background The present study sought to identify a panel of DNA markers for noninvasive diagnosis using cell-free DNA (cfDNA) from urine supernatant or cellular DNA from urine sediments of hematuria patients. A panel of 48 bladder cancer-specific genes was selected. A next-generation sequencing-based assay with a cfDNA barcode-enabled single-molecule test was employed. Mutation profiles of blood, urine, and tumor sample from 16 bladder cancer patients were compared. Next, urinary cellular DNA and cfDNA were prospectively collected from 125 patients (92 bladder cancer cases and 33 controls) and analyzed using the 48-gene panel. The individual gene markers and combinations of markers were validated according to the pathology results. The mean areas under the receiver operating characteristic (ROC) curves (AUCs) obtained with the various modeling approaches were calculated and compared. Results This pilot study of 16 bladder cancer patients demonstrated that gene mutations in urine supernatant and sediments had better concordance with cancer tissue as compared with plasma. Logistic analyses suggested two powerful combinations of genes for genetic diagnostic modeling: five genes for urine supernatant (TERT, FGFR3, TP53, PIK3CA, and KRAS) and seven genes for urine sediments (TERT, FGFR3, TP53, HRAS, PIK3CA, KRAS, and ERBB2). The accuracy of the five-gene panel and the seven-gene panel in the validation cohort yielded AUCs of 0.94 [95% confidence interval (CI) 0.91–0.97] and 0.91 (95% CI 0.86–0.96), respectively. With the addition of age and gender, the diagnostic power of the urine supernatant five-gene model and the urine sediment seven-gene model improved as the revised AUCs were 0.9656 (95% CI 0.9368–0.9944) and 0.9587 (95% CI 0.9291–0.9883). Conclusions cfDNA from urine bears great diagnostic potential. A five-gene panel for urine supernatant and a seven-gene panel for urine sediments are promising options for identifying bladder cancer in hematuria patients.
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Affiliation(s)
- Zhenyu Ou
- Department of Urology, The Third Xiangya Hospital, Central South University, Changsha, 410013, Hunan, China.,Department of Urology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - Kai Li
- GeneTalks Biotech Co., Ltd., Changsha, 410010, Hunan, China
| | - Ting Yang
- GeneTalks Biotech Co., Ltd., Changsha, 410010, Hunan, China
| | - Ying Dai
- GeneTalks Biotech Co., Ltd., Changsha, 410010, Hunan, China
| | - Mohan Chandra
- Department of Biomedical Engineering, University of Houston, Houston, TX, 77204-5060, USA
| | - Jun Ning
- Department of Urology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - Yongli Wang
- GeneTalks Biotech Co., Ltd., Changsha, 410010, Hunan, China
| | - Ran Xu
- Department of Urology, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Tangjie Gao
- GeneTalks Biotech Co., Ltd., Changsha, 410010, Hunan, China
| | - Yu Xie
- Department of Urology, Hunan Provincial Tumor Hospital and Affiliated Tumor Hospital of Xiangya Medical School, Central South University, Changsha, 410013, Hunan, China
| | - Qing He
- GeneTalks Biotech Co., Ltd., Changsha, 410010, Hunan, China
| | - Yuanwei Li
- Department of Urology, Hunan Provincial People's Hospital, Changsha, 410002, Hunan, China
| | - Qin Lu
- GeneTalks Biotech Co., Ltd., Changsha, 410010, Hunan, China
| | - Long Wang
- Department of Urology, The Third Xiangya Hospital, Central South University, Changsha, 410013, Hunan, China. .,Department of Urology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.
| | - Zhuo Song
- GeneTalks Biotech Co., Ltd., Changsha, 410010, Hunan, China.
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29
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Jeeta RR, Gordon NS, Baxter L, Goel A, Noyvert B, Ott S, Boucher RH, Humayun-Zakaria N, Arnold R, James ND, Zeegers MP, Cheng K, Bryan RT, Ward DG. Non-Coding Mutations in Urothelial Bladder Cancer: Biological and Clinical Relevance and Potential Utility as Biomarkers. Bladder Cancer 2019. [DOI: 10.3233/blc-190251] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Ruhana R. Jeeta
- Institute of Cancer & Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Naheema S. Gordon
- Institute of Cancer & Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Laura Baxter
- Department of Computer Science, University of Warwick, Coventry, UK
| | - Anshita Goel
- Institute of Cancer & Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Boris Noyvert
- Institute of Cancer & Genomic Sciences, University of Birmingham, Birmingham, UK
- CRUK Birmingham Centre and Centre for Computational Biology, University of Birmingham, Birmingham, UK
| | - Sascha Ott
- Department of Computer Science, University of Warwick, Coventry, UK
| | - Rebecca H. Boucher
- Institute of Cancer & Genomic Sciences, University of Birmingham, Birmingham, UK
- Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham, UK
| | - Nada Humayun-Zakaria
- Institute of Cancer & Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Roland Arnold
- Institute of Cancer & Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Nicholas D. James
- Institute of Cancer & Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Maurice P. Zeegers
- NUTRIM School for Nutrition and Translational Research in Metabolism & CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - K.K. Cheng
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Richard T. Bryan
- Institute of Cancer & Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Douglas G. Ward
- Institute of Cancer & Genomic Sciences, University of Birmingham, Birmingham, UK
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30
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Ward DG, Gordon NS, Boucher RH, Pirrie SJ, Baxter L, Ott S, Silcock L, Whalley CM, Stockton JD, Beggs AD, Griffiths M, Abbotts B, Ijakipour H, Latheef FN, Robinson RA, White AJ, James ND, Zeegers MP, Cheng KK, Bryan RT. Targeted deep sequencing of urothelial bladder cancers and associated urinary DNA: a 23-gene panel with utility for non-invasive diagnosis and risk stratification. BJU Int 2019; 124:532-544. [PMID: 31077629 PMCID: PMC6772022 DOI: 10.1111/bju.14808] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To develop a focused panel of somatic mutations (SMs) present in the majority of urothelial bladder cancers (UBCs), to investigate the diagnostic and prognostic utility of this panel, and to compare the identification of SMs in urinary cell-pellet (cp)DNA and cell-free (cf)DNA as part of the development of a non-invasive clinical assay. PATIENTS AND METHODS A panel of SMs was validated by targeted deep-sequencing of tumour DNA from 956 patients with UBC. In addition, amplicon and capture-based targeted sequencing measured mutant allele frequencies (MAFs) of SMs in 314 urine cpDNAs and 153 urine cfDNAs. The association of SMs with grade, stage, and clinical outcomes was investigated by univariate and multivariate Cox models. Concordance between SMs detected in tumour tissue and cpDNA and cfDNA was assessed. RESULTS The panel comprised SMs in 23 genes: TERT (promoter), FGFR3, PIK3CA, TP53, ERCC2, RHOB, ERBB2, HRAS, RXRA, ELF3, CDKN1A, KRAS, KDM6A, AKT1, FBXW7, ERBB3, SF3B1, CTNNB1, BRAF, C3orf70, CREBBP, CDKN2A, and NRAS; 93.5-98.3% of UBCs of all grades and stages harboured ≥1 SM (mean: 2.5 SMs/tumour). RAS mutations were associated with better overall survival (P = 0.04). Mutations in RXRA, RHOB and TERT (promoter) were associated with shorter time to recurrence (P < 0.05). MAFs in urinary cfDNA and cpDNA were highly correlated; using a capture-based approach, >94% of tumour SMs were detected in both cpDNA and cfDNA. CONCLUSIONS SMs are reliably detected in urinary cpDNA and cfDNA. The technical capability to identify very low MAFs is essential to reliably detect UBC, regardless of the use of cpDNA or cfDNA. This 23-gene panel shows promise for the non-invasive diagnosis and risk stratification of UBC.
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Affiliation(s)
- Douglas G. Ward
- Institute of Cancer and Genomic SciencesUniversity of BirminghamBirminghamUK
| | - Naheema S. Gordon
- Institute of Cancer and Genomic SciencesUniversity of BirminghamBirminghamUK
| | - Rebecca H. Boucher
- Institute of Cancer and Genomic SciencesUniversity of BirminghamBirminghamUK
| | - Sarah J. Pirrie
- Institute of Cancer and Genomic SciencesUniversity of BirminghamBirminghamUK
| | - Laura Baxter
- Department of Computer ScienceUniversity of WarwickCoventryUK
| | - Sascha Ott
- Department of Computer ScienceUniversity of WarwickCoventryUK
| | - Lee Silcock
- Nonacus LimtedBirmingham Research ParkBirminghamUK
| | - Celina M. Whalley
- Institute of Cancer and Genomic SciencesUniversity of BirminghamBirminghamUK
| | - Joanne D. Stockton
- Institute of Cancer and Genomic SciencesUniversity of BirminghamBirminghamUK
| | - Andrew D. Beggs
- Institute of Cancer and Genomic SciencesUniversity of BirminghamBirminghamUK
| | - Mike Griffiths
- West Midlands Regional Genetics LaboratoryBirmingham Women's and Children's NHS Foundation TrustBirminghamUK
| | - Ben Abbotts
- Institute of Cancer and Genomic SciencesUniversity of BirminghamBirminghamUK
| | - Hanieh Ijakipour
- Institute of Cancer and Genomic SciencesUniversity of BirminghamBirminghamUK
| | | | - Robert A. Robinson
- Institute of Cancer and Genomic SciencesUniversity of BirminghamBirminghamUK
| | - Andrew J. White
- Institute of Cancer and Genomic SciencesUniversity of BirminghamBirminghamUK
| | - Nicholas D. James
- Institute of Cancer and Genomic SciencesUniversity of BirminghamBirminghamUK
| | - Maurice P. Zeegers
- NUTRIM School for Nutrition and Translational Research in Metabolism and CAPHRI Care and Public Health Research InstituteMaastricht UniversityMaastrichtThe Netherlands
| | - K. K. Cheng
- Institute of Applied Health ResearchUniversity of BirminghamBirminghamUK
| | - Richard T. Bryan
- Institute of Cancer and Genomic SciencesUniversity of BirminghamBirminghamUK
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31
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Larsen LK, Lind GE, Guldberg P, Dahl C. DNA-Methylation-Based Detection of Urological Cancer in Urine: Overview of Biomarkers and Considerations on Biomarker Design, Source of DNA, and Detection Technologies. Int J Mol Sci 2019; 20:ijms20112657. [PMID: 31151158 PMCID: PMC6600406 DOI: 10.3390/ijms20112657] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 05/23/2019] [Accepted: 05/24/2019] [Indexed: 12/11/2022] Open
Abstract
Changes in DNA methylation have been causally linked with cancer and provide promising biomarkers for detection in biological fluids such as blood, urine, and saliva. The field has been fueled by genome-wide characterization of DNA methylation across cancer types as well as new technologies for sensitive detection of aberrantly methylated DNA molecules. For urological cancers, urine is in many situations the preferred "liquid biopsy" source because it contains exfoliated tumor cells and cell-free tumor DNA and can be obtained easily, noninvasively, and repeatedly. Here, we review recent advances made in the development of DNA-methylation-based biomarkers for detection of bladder, prostate, renal, and upper urinary tract cancers, with an emphasis on the performance characteristics of biomarkers in urine. For most biomarkers evaluated in independent studies, there was great variability in sensitivity and specificity. We discuss issues that impact the outcome of DNA-methylation-based detection of urological cancer and account for the great variability in performance, including genomic location of biomarkers, source of DNA, and technical issues related to the detection of rare aberrantly methylated DNA molecules. Finally, we discuss issues that remain to be addressed to fully exploit the potential of DNA-methylation-based biomarkers in the clinic, including the need for prospective trials and careful selection of control groups.
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Affiliation(s)
| | - Guro Elisabeth Lind
- Department of Molecular Oncology, Institute for Cancer Research, Oslo University Hospital, the Norwegian Radium Hospital, NO-0424 Oslo, Norway.
| | - Per Guldberg
- Danish Cancer Society Research Center, DK-2100 Copenhagen, Denmark.
| | - Christina Dahl
- Danish Cancer Society Research Center, DK-2100 Copenhagen, Denmark.
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32
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Hayashi Y, Fujita K, Matsuzaki K, Matsushita M, Kawamura N, Koh Y, Nakano K, Wang C, Ishizuya Y, Yamamoto Y, Jingushi K, Kato T, Kawashima A, Ujike T, Nagahara A, Uemura M, Imamura R, Takao T, Takada S, Netto GJ, Nonomura N. Diagnostic potential of TERT promoter and FGFR3 mutations in urinary cell-free DNA in upper tract urothelial carcinoma. Cancer Sci 2019; 110:1771-1779. [PMID: 30887605 PMCID: PMC6501003 DOI: 10.1111/cas.14000] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 03/13/2019] [Accepted: 03/14/2019] [Indexed: 12/14/2022] Open
Abstract
Most upper tract urothelial carcinomas (UTUC) are muscle invasive at the time of diagnosis. Current standard methods for the diagnosis of UTUC are invasive. Urine cytology is the only non-invasive test for detecting UTUC, but its sensitivity is low. A novel non-invasive assay for UTUC detection would improve patient outcome. This study aimed to investigate the mutation of cell-free DNA (cfDNA) in urine supernatant to develop a reliable diagnostic biomarker for UTUC patients. We studied urinary cfDNA from 153 individuals, including 56 patients with localized UTUC, and carried out droplet digital PCR assay for TERT promoter and FGFR3 hotspot mutations. We could detect mutations of TERT C228T in 22/56 (39.3%), TERT C250T in 4/56 (7.1%), and FGFR3 S249C in 9/56 (16.1%) patients. FGFR3 mutation was detected only in ≤pT1 tumors (positive predictive value: 100.0%). In combination with cytology results, the sensitivity was 78.6%, and the specificity was 96.0%. Although these data need to be validated in a larger-scale cohort, mutation analysis of TERT promoter and FGFR3 in urinary cfDNA has the potential to be a non-invasive diagnostic marker and reliable factor for tumor staging.
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Affiliation(s)
- Yujiro Hayashi
- Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Kazutoshi Fujita
- Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Kyosuke Matsuzaki
- Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Makoto Matsushita
- Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan
| | | | - Yoko Koh
- Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Kosuke Nakano
- Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Cong Wang
- Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Yu Ishizuya
- Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Yoshiyuki Yamamoto
- Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Kentaro Jingushi
- Department of Therapeutic Urologic Oncology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Taigo Kato
- Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Atsunari Kawashima
- Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Takeshi Ujike
- Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Akira Nagahara
- Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Motohide Uemura
- Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan.,Department of Therapeutic Urologic Oncology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Ryoichi Imamura
- Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Tetsuya Takao
- Department of Urology, Osaka General Medical Center, Osaka, Japan
| | - Shingo Takada
- Department of Urology, Osaka Police Hospital, Osaka, Japan
| | - George J Netto
- Department Pathology, University of Alabama at Birmingham, Birmingham, USA
| | - Norio Nonomura
- Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan
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33
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Ward DG, Bryan RT. Massively parallel sequencing of urinary DNA-the dawn of non-invasive bladder cancer detection and surveillance? Transl Cancer Res 2019; 8:S204-S207. [PMID: 35117098 PMCID: PMC8797979 DOI: 10.21037/tcr.2019.03.03] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 03/04/2019] [Indexed: 01/01/2023]
Affiliation(s)
- Douglas G Ward
- Institute of Cancer & Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Richard T Bryan
- Institute of Cancer & Genomic Sciences, University of Birmingham, Birmingham, UK
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34
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Gurung PMS, Barnett AR, Wilson JS, Hudson J, Ward DG, Messing EM, Bryan RT. Prognostic DNA Methylation Biomarkers in High-risk Non-muscle-invasive Bladder Cancer: A Systematic Review to Identify Loci for Prospective Validation. Eur Urol Focus 2019; 6:683-697. [PMID: 30803927 DOI: 10.1016/j.euf.2019.02.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 02/13/2019] [Indexed: 02/06/2023]
Abstract
CONTEXT High-risk non-muscle-invasive bladder cancer (HR-NMIBC) represents over 30% of all incident urothelial bladder cancers (BCs); patients are at risk of progression, and 20-30% will die from BC within 5 yr. Current guidelines recommend induction and maintenance of intravesical bacillus Calmette-Guérin (BCG) or upfront radical cystectomy for highest-risk disease, treatments with markedly different morbidity, mortality, and patient burden. There are no validated biomarkers to facilitate such treatment decisions. Alterations in DNA methylation are commonplace in BC; hence, measurable changes in DNA methylation represent an opportunity for the discovery of such biomarkers. OBJECTIVE To systematically assess the evidence regarding DNA methylation markers as prognosticators for HR-NMIBC. EVIDENCE ACQUISITION Standard systematic review methods were employed with searches undertaken in MEDLINE, EMBASE, and PubMed up to January 2019. Studies that included patients with HR-NMIBC and investigated the utility of DNA methylation biomarkers as prognostic tools were included. EVIDENCE SYNTHESIS Of 63 prognostic biomarker studies identified, 21 met the protocol-driven inclusion criteria and were directly relevant to HR-NMIBC patient outcomes: tumour recurrence (TR), tumour progression (TP), disease-specific survival (DSS), and overall survival (OS). These studies described 140 methylation markers; of these, the most promising were cadherin-13 (CDH13; hazard ratios [HRs]: 5.1 for TR, 6.6 for TP, 3.8-8.0 for OS), protocadherins (PCDHs; HRs: 4.7 for TR, 2.5 for TP, 3.0-4.8 for OS), Runt domain transcription factor 3 (RUNX3; HR: 5.1 for TP), Homeobox 9 (HOXA9; HR: 1.9 for TR), Islet-1 (ISL1; HRs: 1.7 for TR, 3.3 for TP), and PAX6 (HR: 2.2 for TR). CONCLUSIONS This systematic review identifies a number of potentially useful prognostic methylation markers for HR-NMIBC. These loci (CDH13, PCDHs, RUNX3, HOXA9, ISL1, and PAX6) should be validated in prospective studies in order to translate benefit to patients. PATIENT SUMMARY Early bladder cancer represents a more complex spectrum of disease than can be assessed by conventional methods Emerging studies on molecular markers will improve our understanding of this disease, and may enable more precise and personalised treatment.
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Affiliation(s)
- Pratik M S Gurung
- University of Rochester Medical Center, Rochester, New York, NY, USA
| | - Abigail R Barnett
- Institute of Cancer & Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Jayne S Wilson
- Institute of Cancer & Genomic Sciences, University of Birmingham, Birmingham, UK
| | | | - Douglas G Ward
- Institute of Cancer & Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Edward M Messing
- University of Rochester Medical Center, Rochester, New York, NY, USA
| | - Richard T Bryan
- Institute of Cancer & Genomic Sciences, University of Birmingham, Birmingham, UK.
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35
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Li P, Ning J, Luo X, Du H, Zhang Q, Zhou G, Du Q, Ou Z, Wang L, Wang Y. New method to preserve the original proportion and integrity of urinary cell-free DNA. J Clin Lab Anal 2019; 33:e22668. [PMID: 30175467 PMCID: PMC6818579 DOI: 10.1002/jcla.22668] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 08/01/2018] [Accepted: 08/10/2018] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Due to high nuclease activity and complex contents in urine, urinary cell-free DNA (ucfDNA) was prone to degrade. So, we developed standardized urine collection tube (UCT) to prevent ucfDNA degradation and simultaneously maintain urinary cells in their original form during the sample collection process, ensuring stabilization of the original proportion and integrity of ucfDNA. METHODS Urine samples were collected from bladder cancer patients and divided into 10-mL normal tubes and 10-mL UCTs, respectively, and kept at ambient temperature. Urine supernatant was separated by centrifuging, and ucfDNA was extracted. Then ucfDNA was quantified by quantitative real-time polymerase chain reaction. UcfDNA fragments distribution was analyzed by Agilent 2200, and the frequency of specific mutations of urinary system disease was detected by next-generation sequencing method. RESULTS Urine collected into UCTs showed no statistically significant changes in their original proportion and integrity of ucfDNA up to 7 days at ambient temperature and also ucfDNA fragments were maintained well. Conversely, urine collected into normal tubes was observed an obviously decline in their original proportion of ucfDNA and ucfDNA fragments changed greatly. The △% of allele fraction (AF) for specific genes of ucfDNA from UCTs was lower than from normal tubes by 3.7-fold. CONCLUSION Using UCTs, they can maximally keep the original proportion and integrity of ucfDNA and stabilize urinary cells and minimize the background noise caused by urinary cellular DNA releasing, it will be help to open the door of next-generation noninvasive liquid biopsy applications utilizing urine.
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Affiliation(s)
- Pei Li
- XiangYa Hospital of Central South UniversityChangshaHunanChina
- Hunan UPSBio, Inc.Hunan University National Science ParkChangshaHunanChina
| | - Jun Ning
- XiangYa Hospital of Central South UniversityChangshaHunanChina
| | - Xipeng Luo
- Hunan UPSBio, Inc.Hunan University National Science ParkChangshaHunanChina
| | - Hongli Du
- School of Bioscience and BioengineeringSouth China University of TechnologyGuangzhouGuangdongChina
| | - Qing Zhang
- Hunan UPSBio, Inc.Hunan University National Science ParkChangshaHunanChina
| | - Ganlin Zhou
- Hunan UPSBio, Inc.Hunan University National Science ParkChangshaHunanChina
| | - Qiu Du
- XiangYa Hospital of Central South UniversityChangshaHunanChina
| | - Zhenyu Ou
- XiangYa Hospital of Central South UniversityChangshaHunanChina
| | - Long Wang
- XiangYa Hospital of Central South UniversityChangshaHunanChina
| | - Yu Wang
- Hunan UPSBio, Inc.Hunan University National Science ParkChangshaHunanChina
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36
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Stasik S, Salomo K, Heberling U, Froehner M, Sommer U, Baretton GB, Ehninger G, Wirth MP, Thiede C, Fuessel S. Evaluation of TERT promoter mutations in urinary cell-free DNA and sediment DNA for detection of bladder cancer. Clin Biochem 2018; 64:60-63. [PMID: 30528938 DOI: 10.1016/j.clinbiochem.2018.11.009] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 11/12/2018] [Accepted: 11/26/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND Cell-free DNA (cfDNA) is proposed to be a valuable source of biomarkers in liquid biopsies for various diseases as it is supposed to partially originate from tumor cells. However, data about the diagnostic implications of cfDNA in urine for the detection of bladder cancer (BCa) is sparse. METHODS We evaluated the usability of urinary cfDNA for diagnostic purposes compared to urine sediment DNA (sDNA) in 53 BCa patients and 36 control subjects by analyzing two abundant point-mutations (C228T/C250T) in the TERT promoter using Next-Generation Sequencing. RESULTS Mutations were detected in 77% of the urinary sDNA compared to 63% of the cfDNA samples. Moreover, the TERT mutation allele frequencies (MAF) were highly correlated in cfDNA and sDNA. In comparison, the accuracy of the TERT assay was higher in sDNA (84%) compared to cfDNA or voided urine cytology (both 77%). Interestingly, MAFs from leukocyte-rich urines were higher in cfDNA than in sDNA, indicating a diagnostic advantage of cfDNA in such urines. CONCLUSIONS Urine-based mutation detection has the ability to augment and surpass voided urine cytology as the current gold-standard for the non-invasive detection and surveillance of BCa. The analysis of cell-free DNA provides no general diagnostic advantage compared to urine sediment DNA.
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Affiliation(s)
- Sebastian Stasik
- Medical Department I, University Hospital and Faculty of Medicine, Technische Universität Dresden, Dresden, Germany; National Center for Tumor Diseases (NCT), Partner site Dresden, Dresden, Germany
| | - Karsten Salomo
- Department of Urology, University Hospital and Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Ulrike Heberling
- Department of Urology, University Hospital and Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Michael Froehner
- Department of Urology, University Hospital and Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Ulrich Sommer
- Institute of Pathology, University Hospital and Faculty of Medicine, Technische Universität Dresden, Dresden, Germany; National Center for Tumor Diseases (NCT), Partner site Dresden, Dresden, Germany
| | - Gustavo B Baretton
- Institute of Pathology, University Hospital and Faculty of Medicine, Technische Universität Dresden, Dresden, Germany; National Center for Tumor Diseases (NCT), Partner site Dresden, Dresden, Germany; Tumor and normal tissue bank of Universitäts KrebsCentrum (UCC), University Hospital and Faculty of Medicine, Technische Universität Dresden, Germany; German Cancer Consortium (DKTK), Dresden, Germany
| | - Gerhard Ehninger
- Medical Department I, University Hospital and Faculty of Medicine, Technische Universität Dresden, Dresden, Germany; National Center for Tumor Diseases (NCT), Partner site Dresden, Dresden, Germany; German Cancer Consortium (DKTK), Dresden, Germany
| | - Manfred P Wirth
- Department of Urology, University Hospital and Faculty of Medicine, Technische Universität Dresden, Dresden, Germany; National Center for Tumor Diseases (NCT), Partner site Dresden, Dresden, Germany; German Cancer Consortium (DKTK), Dresden, Germany
| | - Christian Thiede
- Medical Department I, University Hospital and Faculty of Medicine, Technische Universität Dresden, Dresden, Germany; National Center for Tumor Diseases (NCT), Partner site Dresden, Dresden, Germany; German Cancer Consortium (DKTK), Dresden, Germany
| | - Susanne Fuessel
- Department of Urology, University Hospital and Faculty of Medicine, Technische Universität Dresden, Dresden, Germany; National Center for Tumor Diseases (NCT), Partner site Dresden, Dresden, Germany.
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37
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Palsgrove DN, Taheri D, Springer SU, Cowan M, Guner G, Mendoza Rodriguez MA, Rodriguez Pena MDC, Wang Y, Kinde I, Ricardo BFP, Cunha I, Fujita K, Ertoy D, Kinzler KW, Bivalacqua TJ, Papadopoulos N, Vogelstein B, Netto GJ. Targeted sequencing of plasmacytoid urothelial carcinoma reveals frequent TERT promoter mutations. Hum Pathol 2018; 85:1-9. [PMID: 30447301 DOI: 10.1016/j.humpath.2018.10.033] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 10/25/2018] [Accepted: 10/31/2018] [Indexed: 02/07/2023]
Abstract
Activating mutations in the promoter of the telomerase reverse transcriptase (TERT) gene are the most common genetic alterations in urothelial carcinoma (UC) of the bladder and upper urinary tract. Although the cadherin 1 (CDH1) gene is commonly mutated in the clinically aggressive plasmacytoid variant of urothelial carcinoma (PUC), little is known about their TERT promoter mutation status. A retrospective search of our archives for PUC and UC with plasmacytoid and/or signet ring cell features (2007-2014) was performed. Ten specimens from 10 patients had archived material available for DNA analysis and were included in the study. Intratumoral areas of nonplasmacytoid histology were also evaluated when present. Samples were analyzed for TERT promoter mutations with Safe-SeqS, a sequencing error-reduction technology, and sequenced using a targeted panel of the 10 most commonly mutated genes in bladder cancer on the Illumina MiSeq platform. TERT promoter mutations were detected in specimens with pure and focal plasmacytoid features (6/10). Similar to conventional UC, the predominant mutation identified was g.1295228C>T. In heterogeneous tumors with focal variant histology, concordant mutations were found in plasmacytoid and corresponding conventional, glandular, or sarcomatoid areas. Co-occurring mutations in tumor protein p53 (TP53, 2 cases) and kirsten rat sarcoma (KRAS) viral proto-oncogene (1 case) were also detected. TERT promoter mutations are frequently present in PUC, which provides further evidence that TERT promoter mutations are common events in bladder cancer, regardless of histologic subtype, and supports their inclusion in any liquid biopsy assay for bladder cancer.
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Affiliation(s)
- Doreen N Palsgrove
- Department of Pathology, Johns Hopkins University, Baltimore, MD 21287, USA
| | - Diana Taheri
- Department of Pathology, Johns Hopkins University, Baltimore, MD 21287, USA; Department of Pathology, Isfahan University of Medical Sciences, Isfahan Kidney Diseases Research Center, Isfahan 81746 73461, Iran
| | - Simeon U Springer
- Department of Oncology, Johns Hopkins University, Baltimore, MD 21287, USA; The Ludwig Center for Cancer Genetics and Therapeutics and Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD 21287, USA
| | - Morgan Cowan
- Department of Pathology, Johns Hopkins University, Baltimore, MD 21287, USA
| | - Gunes Guner
- Department of Pathology, Johns Hopkins University, Baltimore, MD 21287, USA
| | | | - Maria Del Carmen Rodriguez Pena
- Department of Pathology, Johns Hopkins University, Baltimore, MD 21287, USA; Department of Pathology, University of Alabama at Birmingham, Birmingham, AL 35249, USA
| | - Yuxuan Wang
- The Ludwig Center for Cancer Genetics and Therapeutics and Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD 21287, USA
| | - Isaac Kinde
- The Ludwig Center for Cancer Genetics and Therapeutics and Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD 21287, USA
| | | | - Isabela Cunha
- Department of Pathology, Rede D'OR São Luiz, São Paulo 03313-000, Brazil
| | | | - Dilek Ertoy
- Department of Pathology, Koç University, İstanbul 34450, Turkey
| | - Kenneth W Kinzler
- Department of Oncology, Johns Hopkins University, Baltimore, MD 21287, USA; The Ludwig Center for Cancer Genetics and Therapeutics and Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD 21287, USA
| | | | - Nickolas Papadopoulos
- Department of Oncology, Johns Hopkins University, Baltimore, MD 21287, USA; The Ludwig Center for Cancer Genetics and Therapeutics and Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD 21287, USA
| | - Bert Vogelstein
- Department of Oncology, Johns Hopkins University, Baltimore, MD 21287, USA; The Ludwig Center for Cancer Genetics and Therapeutics and Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD 21287, USA
| | - George J Netto
- Department of Pathology, Johns Hopkins University, Baltimore, MD 21287, USA; Department of Pathology, University of Alabama at Birmingham, Birmingham, AL 35249, USA.
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