|
1
|
Kim SK, Park SH, Kim YU, Byun YJ, Piao XM, Jeong P, Kim K, Lee HY, Seo SP, Kang HW, Kim WT, Kim YJ, Lee SC, Moon SK, Choi YH, Kim WJ, Kim SY, Yun SJ. A Molecular Signature Determines the Prognostic and Therapeutic Subtype of Non-Muscle-Invasive Bladder Cancer Responsive to Intravesical Bacillus Calmette-Guérin Therapy. Int J Mol Sci 2021; 22:1450. [PMID: 33535616 PMCID: PMC7867154 DOI: 10.3390/ijms22031450] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 01/26/2021] [Accepted: 01/28/2021] [Indexed: 11/16/2022] Open
Abstract
Non-muscle-invasive bladder cancer (NMIBC) is clinically heterogeneous; thus, many patients fail to respond to treatment and relapse. Here, we identified a molecular signature that is both prognostic and predictive for NMIBC heterogeneity and responses to Bacillus Calmette-Guérin (BCG) therapy. Transcriptomic profiling of 948 NMIBC patients identified a signature-based subtype predictor, MSP888, along with three distinct molecular subtypes: DP.BCG+ (related to progression and response to BCG treatment), REC.BCG+ (related to recurrence and response to BCG treatment), and EP (equivocal prognosis). Patients with the DP.BCG+ subtype showed worse progression-free survival but responded to BCG treatment, whereas those with the REC.BCG+ subtype showed worse recurrence-free survival but responded to BCG treatment. Multivariate analyses revealed that MSP888 showed independent clinical utility for predicting NMIBC prognosis (each p = 0.001 for progression and recurrence, respectively). Comparative analysis of this classifier and previously established molecular subtypes (i.e., Lund taxonomy and UROMOL class) revealed that a great proportion of patients were similar between subtypes; however, the MSP888 predictor better differentiated biological activity or responsiveness to BCG treatment. Our data increase our understanding of the mechanisms underlying the poor prognosis of NMIBC and the effectiveness of BCG therapy, which should improve clinical practice and complement other diagnostic tools.
Collapse
Affiliation(s)
- Seon-Kyu Kim
- Personalized Genomic Medicine Research Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), Daejeon 34141, Korea; (S.-K.K.); (S.-H.P.); (S.-Y.K.)
- Department of Bioinformatics, KRIBB School of Bioscience, Korea University of Science and Technology, Daejeon 34113, Korea
| | - Seong-Hwan Park
- Personalized Genomic Medicine Research Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), Daejeon 34141, Korea; (S.-K.K.); (S.-H.P.); (S.-Y.K.)
- Department of Bioinformatics, KRIBB School of Bioscience, Korea University of Science and Technology, Daejeon 34113, Korea
| | - Yeong Uk Kim
- Department of Urology, College of Medicine, Yeungnam University, Daegu 38541, Korea;
| | - Young Joon Byun
- Department of Urology, Chungbuk National University College of Medicine, Cheongju 28644, Korea; (Y.J.B.); (X.-M.P.); (P.J.); (K.K.); (H.Y.L.); (S.P.S.); (H.W.K.); (W.T.K.); (Y.-J.K.); (S.-C.L.); (W.-J.K.)
| | - Xuan-Mei Piao
- Department of Urology, Chungbuk National University College of Medicine, Cheongju 28644, Korea; (Y.J.B.); (X.-M.P.); (P.J.); (K.K.); (H.Y.L.); (S.P.S.); (H.W.K.); (W.T.K.); (Y.-J.K.); (S.-C.L.); (W.-J.K.)
| | - Pildu Jeong
- Department of Urology, Chungbuk National University College of Medicine, Cheongju 28644, Korea; (Y.J.B.); (X.-M.P.); (P.J.); (K.K.); (H.Y.L.); (S.P.S.); (H.W.K.); (W.T.K.); (Y.-J.K.); (S.-C.L.); (W.-J.K.)
| | - Kyeong Kim
- Department of Urology, Chungbuk National University College of Medicine, Cheongju 28644, Korea; (Y.J.B.); (X.-M.P.); (P.J.); (K.K.); (H.Y.L.); (S.P.S.); (H.W.K.); (W.T.K.); (Y.-J.K.); (S.-C.L.); (W.-J.K.)
- Department of Urology, Chungbuk National University Hospital, Cheongju 28644, Korea
| | - Hee Youn Lee
- Department of Urology, Chungbuk National University College of Medicine, Cheongju 28644, Korea; (Y.J.B.); (X.-M.P.); (P.J.); (K.K.); (H.Y.L.); (S.P.S.); (H.W.K.); (W.T.K.); (Y.-J.K.); (S.-C.L.); (W.-J.K.)
- Department of Urology, Chungbuk National University Hospital, Cheongju 28644, Korea
| | - Sung Pil Seo
- Department of Urology, Chungbuk National University College of Medicine, Cheongju 28644, Korea; (Y.J.B.); (X.-M.P.); (P.J.); (K.K.); (H.Y.L.); (S.P.S.); (H.W.K.); (W.T.K.); (Y.-J.K.); (S.-C.L.); (W.-J.K.)
- Department of Urology, Chungbuk National University Hospital, Cheongju 28644, Korea
| | - Ho Won Kang
- Department of Urology, Chungbuk National University College of Medicine, Cheongju 28644, Korea; (Y.J.B.); (X.-M.P.); (P.J.); (K.K.); (H.Y.L.); (S.P.S.); (H.W.K.); (W.T.K.); (Y.-J.K.); (S.-C.L.); (W.-J.K.)
- Department of Urology, Chungbuk National University Hospital, Cheongju 28644, Korea
| | - Won Tae Kim
- Department of Urology, Chungbuk National University College of Medicine, Cheongju 28644, Korea; (Y.J.B.); (X.-M.P.); (P.J.); (K.K.); (H.Y.L.); (S.P.S.); (H.W.K.); (W.T.K.); (Y.-J.K.); (S.-C.L.); (W.-J.K.)
- Department of Urology, Chungbuk National University Hospital, Cheongju 28644, Korea
| | - Yong-June Kim
- Department of Urology, Chungbuk National University College of Medicine, Cheongju 28644, Korea; (Y.J.B.); (X.-M.P.); (P.J.); (K.K.); (H.Y.L.); (S.P.S.); (H.W.K.); (W.T.K.); (Y.-J.K.); (S.-C.L.); (W.-J.K.)
- Department of Urology, Chungbuk National University Hospital, Cheongju 28644, Korea
| | - Sang-Cheol Lee
- Department of Urology, Chungbuk National University College of Medicine, Cheongju 28644, Korea; (Y.J.B.); (X.-M.P.); (P.J.); (K.K.); (H.Y.L.); (S.P.S.); (H.W.K.); (W.T.K.); (Y.-J.K.); (S.-C.L.); (W.-J.K.)
- Department of Urology, Chungbuk National University Hospital, Cheongju 28644, Korea
| | - Sung-Kwon Moon
- Department of Food and Nutrition, College of Biotechnology & Natural Resource, Chung-Ang University, Anseong 06974, Korea;
| | - Yung Hyun Choi
- Department of Urology, Personalized Tumor Engineering Research Center, Chungbuk National University College of Medicine, Cheongju 28644, Korea;
| | - Wun-Jae Kim
- Department of Urology, Chungbuk National University College of Medicine, Cheongju 28644, Korea; (Y.J.B.); (X.-M.P.); (P.J.); (K.K.); (H.Y.L.); (S.P.S.); (H.W.K.); (W.T.K.); (Y.-J.K.); (S.-C.L.); (W.-J.K.)
- Department of Urology, Chungbuk National University Hospital, Cheongju 28644, Korea
| | - Seon-Young Kim
- Personalized Genomic Medicine Research Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), Daejeon 34141, Korea; (S.-K.K.); (S.-H.P.); (S.-Y.K.)
- Korea Bioinformation Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), Daejeon 34141, Korea
| | - Seok Joong Yun
- Department of Urology, Chungbuk National University College of Medicine, Cheongju 28644, Korea; (Y.J.B.); (X.-M.P.); (P.J.); (K.K.); (H.Y.L.); (S.P.S.); (H.W.K.); (W.T.K.); (Y.-J.K.); (S.-C.L.); (W.-J.K.)
- Department of Urology, Chungbuk National University Hospital, Cheongju 28644, Korea
| |
Collapse
|