Abstract 6417: Urinary PKM2 in muscle invasive bladder cancer

Abstract

Abstract Background & Aims: Biomarkers are commonly used for both detection of cancer and monitoring response to treatment. Although several biomarkers have demonstrated promise in patients with bladder cancer (BCa), only urine cytology is widely utilized. Increased availability of effective biomarkers may improve clinical decision making and reduce the need for more invasive imaging. The M2 isoform of pyruvate kinase (PKM2) is upregulated in a number of cancers, including BCa, and promotes metabolic changes, including a shift to aerobic glycolysis. The aim of this study was to determine whether urine PKM2 levels are useful for detection and monitoring response to cisplatin-based neoadjuvant chemotherapy in patients with muscle invasive BCa. Methods: Urine samples from patients enrolled in the University of Kanas Medical Center Bladder Cancer Biorepository were analyzed for levels of PKM2. Patients were included if they had both T2 stage disease and had received cisplatin-based neoadjuvant chemotherapy and were compared to healthy controls. Patients were categorized based on their pathological response to treatment and recurrence of disease within two years of definitive surgery. Urinary PKM2 levels were measured and evaluated for their ability to predict response to treatment and two-year disease-free survival. Results: Immunohistochemistry revealed high levels of PKM2 within muscle invasive tumors compared to adjacent tissue. Patients with BCa had 150-fold increase in levels of urinary PKM2 compared to controls. However, there were no differences in urine PKM2 levels in patients with complete pathological response compared to those with no response. Urine PKM2 showed limited predictive value for disease recurrence (area under receiver operating characteristic curve = 0.65). Conclusion: Urine levels of PKM2 are significantly elevated in patients with muscle invasive BCa and may be useful for tumor detection. Urinary PKM2 is less effective at monitoring response to treatment and may instead represent a marker of urothelial susceptibility to tumor formation. Citation Format: David Matye, Juliann Leak, Erika Abbott, Benjamin Woolbright, John Taylor. Urinary PKM2 in muscle invasive bladder cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 6417.