Mp71-01 Unlocking the Potential of Urinary Mutation and Methylation Biomarkers: A Game-Changing Approach to Optimizing Candidates of Nmibc for Repeated Turbt—a Prospective Multicenter Study

You have accessJournal of UrologyBladder Cancer: Non-invasive IV (MP71)1 May 2024MP71-01 UNLOCKING THE POTENTIAL OF URINARY MUTATION AND METHYLATION BIOMARKERS: A GAME-CHANGING APPROACH TO OPTIMIZING CANDIDATES OF NMIBC FOR REPEATED TURBT—A PROSPECTIVE MULTICENTER STUDY Qiang Lyu, Xiao Yang, and Qiang Cao Qiang LyuQiang Lyu , Xiao YangXiao Yang , and Qiang CaoQiang Cao View All Author Informationhttps://doi.org/10.1097/01.JU.0001009548.76580.ba.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The necessity of repeated transurethral resection of bladder tumor (re-TURBT) for non-muscle-invasive bladder cancer (NMIBC) patients remains debated. Liquid biopsy's role in predicting tumor residual status and determining patients who can spare re-TURBT is still undefined. We want to assess the efficacy of OncoUrine, a urinary assay for mutation and methylation markers, in determining the necessity of re-TURBT. METHODS: Prospective study of NMIBC patients from 4 centers assessed OncoUrine analysis using urine samples collected 2-6 weeks after initial TURBT, followed by re-TURBT. The primary outcome is to assess OncoUrine's capability to predict tumor residual status in re-TURBT, and secondly, its efficacy in predicting recurrence. RESULTS: Of the 151 NMIBC patients enrolled, 48 (31.8%) had residual tumors in re-TURBT, while 87 (57.6%) achieved complete resection with detrusor muscle (DM). Risk distribution included: 1 low-risk, 58 intermediate-risk, 83 high-risk, and 9 very high-risk. OncoUrine test showed a sensitivity (SN) of 77.1%, specificity (SP) of 77.7%, positive predictive value (PPV) of 61.7%, and negative predictive value (NPV) of 87.9% in predicting tumor residual status. Stratified analysis revealed that OncoUrine's accuracy in identifying disease-free intermediate-risk patients, with a 97.6% NPV, potentially avoiding 70.7% unnecessary re-TURBT. In high-risk patients with DM, it had a 92.0% NPV, could sparing 50.0% from re-TURBT. Over a median 12.1-month follow-up of 131 patients, 18 patients experienced tumor recurrence. Positive OncoUrine (HR=3.70, p=0.019) and multiple tumors (HR=11.21, p=0.019) are two independent recurrence risk factors according to multivariate analysis. CONCLUSIONS: The OncoUrine test prior to re-TURBT can potentially avoid unnecessary surgery, especially for intermediate-risk NMIBC and high-risk NMIBC with DM. Those patients with positive OncoUrine results are at a higher recurrence risk and should consider re-TURBT to reduce tumor residual. Download PPTDownload PPT Source of Funding: This study has received funding by the National Natural Science Foundation of China. (No: 82072832, 82273152) © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1160 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Qiang Lyu More articles by this author Xiao Yang More articles by this author Qiang Cao More articles by this author Expand All Advertisement PDF downloadLoading ...