PD47-08 PREDICTION OF RESPONSE TO BCG IN PATIENTS WITH NON-MUSCLE INVASIVE BLADDER CANCER OF HIGH RISK USING MOLECULAR PROFILE

You have accessJournal of UrologyBladder Cancer: Epidemiology & Evaluation II (PD47)1 Sep 2021PD47-08 PREDICTION OF RESPONSE TO BCG IN PATIENTS WITH NON-MUSCLE INVASIVE BLADDER CANCER OF HIGH RISK USING MOLECULAR PROFILE Mohamed Abdelbaset, Mohamad H. Zahran, Ahmed El-Assmy, Rawdy Ashour, Amira Awadalla, Sherry Khater, El-Housseiny Ismail Ibrahiem, and Ahmed Shokier Mohamed AbdelbasetMohamed Abdelbaset More articles by this author , Mohamad H. ZahranMohamad H. Zahran More articles by this author , Ahmed El-AssmyAhmed El-Assmy More articles by this author , Rawdy AshourRawdy Ashour More articles by this author , Amira AwadallaAmira Awadalla More articles by this author , Sherry KhaterSherry Khater More articles by this author , El-Housseiny Ismail IbrahiemEl-Housseiny Ismail Ibrahiem More articles by this author , and Ahmed ShokierAhmed Shokier More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002069.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: To evaluate the prognostic role of PD1/PDL1 expression in exclusively high risk T1G3 patients with non-muscle-invasive bladder cancer (NMIBC) as predictors of BCG response post TURBT. METHODS: In an observational prospective non-concurrent study between January 2018 and January 2021. Patients with exclusively T1G3 high risk NMIBC who were treated by TURBT followed by intravesical BCG and followed-up for at least 2 years were included. Clinico-pathological data were retrieved and mRNA expression of PD1, PDL1, miRNA-140 and mRNA-200 in both blood and formalin-fixed paraffin-embedded tissues (FFPE) of resected tissue were measured by single step RT-qPCR. Also, immunohistochemical (IHC) PDL-1 expression was estimated in resected tumor. The primary outcome was to correlate the gene expression on both tissue and blood to BCG response (either tumor recurrence or progression to muscle-invasive cancer MIBC). A recurrence was defined as histopathologically proven NMIBC. Tumor grade was assessed based on the 1973 WHO classification. Progression was defined as the histologic confirmation of MIBC. RESULTS: The study included 119 patients (105 males and 14 females) with mean age 68±8.1 years. Forty-eight patients (40.3%) responded to BCG with no recurrence or progression (group A) and 71 patients (59.7%) were non-responders (group B). Fifty six patients (47.1%) developed T1G3 recurrence and 25 patients (21%) had tumor progression to MIBC. Strong direct correlation was found between mRNA expression of PDL1 in both tissue and blood (r=0.92 & p=<0.0001). PDL1 gene expression in tissue and blood had direct strong correlation with PD1 in both tissue and blood (p=<0.0001) and fair inverse correlation with mRNA-200 and mRNA-140 expression in tissue and blood (p=<0.0001). BCG non-responders had statistically significant higher PD1 and PDL1 in both blood and tissue (p <0.0001) and lower expression of mRNA-140 and mRNA-200 in blood and tissue (p <0.001). ROC curve was done to identify cut-off values for significant continuous data. In multivariate analysis, elevated mRNA expression of PDL-1 in tissue > 5.3 (PPV=89%) and in blood >5.1 (PPV=98%) were associated with poor response to BCG after TURBT [RR, 95% CI of 2.3 (1.56-7.32), 1.5 (1.15-4.6) and 1.54 (1.27-1.87), respectively (p=<0.0001). No correlation was found between significant parameters and clinicopathological characteristics of patients and tumor. CONCLUSIONS: Positive IHC PDL-1 expression and elevated mRNA expression of PDL-1 in tissue > 5.3 are predictors for BCG failure. Higher PDL1 mRNA expression in blood > 5.1 can be used as a non-invasive tool to predict BCG response post TURBT in exclusively T1G3 NMIBC. Early detection of BCG failure could decrease the cost and side effects of BCG treatment. Source of Funding: No funds were received © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e835-e835 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mohamed Abdelbaset More articles by this author Mohamad H. Zahran More articles by this author Ahmed El-Assmy More articles by this author Rawdy Ashour More articles by this author Amira Awadalla More articles by this author Sherry Khater More articles by this author El-Housseiny Ismail Ibrahiem More articles by this author Ahmed Shokier More articles by this author Expand All Advertisement PDF downloadLoading ...