MP16-07 CAN WE PREDICT OF THE RESPONSE OF HIGH RISK NON MUSCLE INVASIVE BLADDER CANCER PATIENTS TO INTRAVESICAL BACILLUS CALMETTE-GUERIN? THE ROLE OF IMMUNOLOGICAL MARKERS

Abstract

You have accessJournal of UrologyBladder Cancer: Non-invasive II (MP16)1 Sep 2021MP16-07 CAN WE PREDICT OF THE RESPONSE OF HIGH RISK NON MUSCLE INVASIVE BLADDER CANCER PATIENTS TO INTRAVESICAL BACILLUS CALMETTE-GUERIN? THE ROLE OF IMMUNOLOGICAL MARKERS Ahmed Elbatta, Amr Elsawy, Hassan abol-Enein, Abdel-Aziz Zeidan, Mohamed Zahran, Mohamed shehata, Ahmed A. Shokeir, and Amira Awadalla Ahmed ElbattaAhmed Elbatta More articles by this author , Amr ElsawyAmr Elsawy More articles by this author , Hassan abol-Enein Hassan abol-Enein More articles by this author , Abdel-Aziz ZeidanAbdel-Aziz Zeidan More articles by this author , Mohamed ZahranMohamed Zahran More articles by this author , Mohamed shehataMohamed shehata More articles by this author , Ahmed A. ShokeirAhmed A. Shokeir More articles by this author , and Amira AwadallaAmira Awadalla More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002001.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: To assess the predictive performance of different immunological markers on BCG-response in high risk NMIBC BCG-naïve patients. METHODS: Patients who underwent TURBT for NMIBC were assessed for study eligibility. Urine and blood samples were retrieved from study participants at baseline (immediately before 1st dose of induction) and after induction (4 hours after last 6th dose). Urine samples were evaluated for IL-2 and IL-10 by solid phase ELISA. Blood samples were evaluated for TNF-α, CTLA4 and transcription factors (TFs) (GATA3+, T-bet+ and FoxP3+) using quantitative RT-PCR analysis. Change pattern and fold change of each evaluable marker was assessed in relation to different oncological outcomes of BCG-response (Initial complete response -ICR-/Recurrence /Progression). RESULTS: Between July 2013 and May 2019, 204 patients were included. Among evaluable markers, IL-2 and TNF-α absolutely increased all patients, CTLA4 and FoxP3+ showed a predominant decrease pattern in 188 (92.2%) and 192 (94.1%) patients, respectively, while, IL-10, GATA3+ and T-bet+ did not show any predominant change pattern. ICR was achieved in 186 (91.2%) patients. TNF-α fold change, IL-10 change pattern were significantly associated with ICR (p= 0.001, 0.03, respectively). At a median (range) follow-up 37 (20-88) months, 104 (56%) patients developed recurrence. IL-10, CTLA4, T-bet+, FoxP3+ change patterns and GATA3+/ T-bet+ ratio were significantly associated with tumor recurrence (p=0.001, 0.001, 0.02, 0.009 and 0.001, respectively). Tumor progression was encountered in 34 (18.3%) patients. IL-10, CTLA4, T-bet+ change patterns and GATA3+/ T-bet+ ratio were independent predictors of tumor progression (p=0.001, 0.001, 0.02 and 0.001, respectively). CONCLUSIONS: Urinary IL-10 and blood TNF-α can significantly predict ICR. Moreover, change pattern of IL-10, CTLA4, TFs (GATA3+, T-bet+ and FoxP3+) and GATA3+/T-bet+ ratio after BCG induction can independently predict further BCG-response. These markers might be implanted in clinical practice when management options are discussed or in systems with severe BCG shortage. Source of Funding: Self © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e298-e298 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ahmed Elbatta More articles by this author Amr Elsawy More articles by this author Hassan abol-Enein More articles by this author Abdel-Aziz Zeidan More articles by this author Mohamed Zahran More articles by this author Mohamed shehata More articles by this author Ahmed A. Shokeir More articles by this author Amira Awadalla More articles by this author Expand All Advertisement Loading ...