Association of immunohistochemical markers of tumor subtype with response to neoadjuvant chemotherapy and survival in patients with muscle-invasive bladder cancer

Association of immunohistochemical markers of tumor subtype with response to neoadjuvant chemotherapy and survival in patients with muscle-invasive bladder cancer

A readily accessible biomarker to identify which patients with bladder cancer are more likely to respond to neoadjuvant chemotherapy (NAC) could help clinicians avoid unnecessary chemotherapy and prevent its subsequent complications in some patients. The primary objective of this study was to invest...

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Bibliographic Details
Published in:Investigative and clinical urology Vol. 62; no. 3; pp. 274 - 281
Main Authors: Razzaghdoust, Abolfazl, Ghajari, Mahdi, Basiri, Abbas, Torbati, Peyman Mohammadi, Jafari, Anya, Fattahi, Mohammad Reza, Salahi, Maryam, Mofid, Bahram
Format: Journal Article
Language:English
Published: Korea (South) The Korean Urological Association 01-05-2021
Korean Urological Association
대한비뇨의학회
Subjects:
Aged
Antineoplastic Agents - therapeutic use
biomarker
Biomarkers - metabolism
bladder cancer
chemotherapy
Chemotherapy, Adjuvant
Cystectomy
Female
Humans
Immunohistochemistry
Keratin-20 - metabolism
Keratin-5 - metabolism
Keratin-6 - metabolism
Logistic Models
Male
Middle Aged
Neoadjuvant Therapy
Neoplasm Invasiveness
Original
Proportional Hazards Models
Retrospective Studies
Survival Rate
Urinary Bladder Neoplasms - metabolism
Urinary Bladder Neoplasms - mortality
Urinary Bladder Neoplasms - therapy
비뇨기과학
Immunohistochemistry
Biomarker
Chemotherapy
Bladder cancer
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Summary:A readily accessible biomarker to identify which patients with bladder cancer are more likely to respond to neoadjuvant chemotherapy (NAC) could help clinicians avoid unnecessary chemotherapy and prevent its subsequent complications in some patients. The primary objective of this study was to investigate the association of immunohistochemical markers of tumor subtype with response to NAC and survival of patients with muscle-invasive bladder cancer (MIBC). MIBC patients treated with NAC were retrospectively included. The tissue microarrays were assembled from transurethral resection of bladder tumor (TURBT) specimens and immunohistochemistry (IHC) was performed. The association of independent variables, including IHC markers, and clinical covariates with clinical complete response to NAC and with overall survival was assessed by using logistic regression and Cox proportional hazard regression analysis, respectively. Kaplan-Meier curves were plotted for different IHC-based tumor subtypes. Data from 140 MIBC patients treated with NAC were retrospectively reviewed. A total of 63 patients with available TURBT specimens were eligible to be included in the analysis. Our results showed that the IHC signature of KRT5/6(+)/KRT20(-), as a combined marker of basal subtype, was the only covariate significantly associated with complete response to NAC (p=0.037). Moreover, we found no statistically significant differences in overall survival between different IHC-based subtypes (p=0.721). The IHC expression of KRT5/6 and KRT20, as a readily accessible combined marker, may help us to identify the patients most likely to benefit from chemotherapy. The clinical utility of this marker needs to be established in larger prospective studies.
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These authors contributed equally to this study and should be considered co-first authors.
https://www.icurology.org/pdf/10.4111/icu.20200425
ISSN:2466-0493
2466-054X
DOI:10.4111/icu.20200425