A novel genomic-based signature provides a more accurate way to identify patients who may experience recurrence of high-risk bladder cancer following cystectomy, according to a new study.

Using whole transcriptome profiling on 225 patients who underwent radical cystectomy for muscle-invasive bladder cancer, Anirban P. Mitra, MD, PhD, of the Center for Personalized Medicine at the University of Southern California in Los Angeles, and collaborators identified 15 markers that could robustly and reproducibly predict disease recurrence.

This 15-feature “genomic classifier” (GC), which was independently validated on 341 patients, surpassed the prognostic potential of standard clinical variables and previously reported genomic signatures for muscle-invasive bladder cancer, the researchers reported online ahead of print in the Journal of the National Cancer Institute.

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According to the researchers, the GC could improve identification of patients who may benefit from more aggressive treatment, such as adjuvant chemotherapy. “Identification of candidates at highest risk for recurrence who may need adjuvant therapy is currently based on clinical criteria that may not reflect the entire biology of the disease,” the authors wrote.

“We expect this study to provide better understanding of the molecular alterations associated with aggressive bladder cancer, and how one can manage individual patients based on their genomic profiles,” Dr. Mitra told Renal & Urology News.

The study was a joint effort led by investigators at the University of Southern California in collaboration with the University of British Columbia in Vancouver, Stanford University in Palo Alto, Calif., and a Vancouver-based company.