Researchers have developed a urine test that can screen for tumor DNA and detect whether a patient has residual bladder cancer after they have undergone surgery to remove the tumor. This test may also detect whether immunotherapy treatment administered after surgery has been effective or residual bladder cancer remains.
The study containing those findings appeared in the journal Cell. If this urine test is successfully validated in larger clinical trials, it could mark a major shift in the way bladder cancer is treated.
Conventionally, bladder cancer is monitored by obtaining a tissue sample for molecular analysis. This approach is costly and subjects patients to several invasive procedures. With this new test, all a patient needs to provide is a urine sample and the necessary analysis to look for tumor DNA will be done.
The researchers from Stanford University faced a challenge of distinguishing between actual tumor DNA and DNA that has been altered by factors like old age of the patient to falsely indicate cancer.
To fix this cause of false positives, the team tweaked their test so that the analytical method used corrects for genetic alterations linked to aging. The scientists then tested the approach and found that three categories of results were possible after a patient has undergone surgery to remove a tumor in their bladder.
First, urine analysis could reveal which patients were cured by the surgery alone and didn’t require additional treatment. Secondly, the urine test revealed which patients were cured after undergoing BCG immunotherapy post-surgery. The particular patients who needed the immunotherapy after surgery could also be identified by the urine test.
The third category of test results was for patients that couldn’t be cured by surgery and the cancer remained even after BCG immunotherapy. These patients stand a high chance of the cancer recurring.
The potential of this test is vast. The test could help in identifying bladder cancer sooner than has previously been possible, thereby allowing clinicians to initiate treatment a lot earlier before disease progression. The test may also prevent the administration of additional treatment, such as BCG immunotherapy, to patients that have been successfully treated through surgical intervention. In this way, the BCG doses can be spared for those who need them the most.
Additionally, the test could also predict which patients are unlikely to respond to the BCG immunotherapy, and such patients can be considered for alternative interventions.
As more forms of immunotherapy are developed by companies like Calidi Biotherapeutics Inc. (NYSE American: CLDI) that are indicated for different cancers, non-invasive tests like the urine test in this study could play a major role in identifying patients who could benefit from these novel treatments and redirect others who are likely to be unresponsive.
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