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Biomarker-Based Nomogram to Predict Neoadjuvant Chemotherapy Response in Muscle-Invasive Bladder Cancer
Meritxell Pérez1, Juan José Lozano2, Mercedes Ingelmo-Torres3
1Department of Urology, Hospital Universitari Terrassa, 08221 Terrassa, Spain.
Biomedicines
|March 28, 2025
Summary
This study identified gene expression biomarkers to predict treatment response and prognosis in muscle-invasive bladder cancer (MIBC) patients receiving neoadjuvant chemotherapy (NAC). A developed nomogram combines clinical and gene data for better prediction of downstaging and relapse.
Area of Science:
- Oncology
- Genomics
- Translational Research
Background:
- Muscle-invasive bladder cancer (MIBC) necessitates effective treatment strategies.
- Neoadjuvant chemotherapy (NAC) is a standard treatment for MIBC, but predicting response and prognosis remains challenging.
- Identifying reliable biomarkers is crucial for personalized treatment approaches.
Purpose of the Study:
- To identify biomarkers for predicting response to NAC in MIBC patients.
- To develop prognostic models for predicting tumor downstaging and relapse after NAC.
- To integrate clinical and gene expression data for improved predictive accuracy.
Main Methods:
- Retrospective multicenter study of 191 MIBC patients treated with NAC before radical cystectomy.
- Gene expression profiling using Illumina microarrays on tumor samples.
- Validation of selected genes by quantitative PCR in an independent cohort of 157 patients.
- Development of a nomogram incorporating clinical and gene expression variables for predicting downstaging and relapse.
Main Results:
- Significant differences in gene expression patterns were observed between NAC responders and non-responders.
- A nomogram incorporating clinical factors (age, Tis, gender, NMIBC history, lymphadenopathy) and specific genes (CBTB16, CHMP6, DDX54, CASP8, LOR, PLEC) was developed.
- A three-gene prognostic model accurately predicted tumor relapse (HR: 2.11, p=0.01).
Conclusions:
- The developed nomogram, integrating gene expression and clinical data, is a valuable tool for predicting downstaging and tumor relapse in MIBC patients undergoing NAC.
- The findings support the potential of gene expression biomarkers in guiding treatment decisions for MIBC.
- Further validation studies are recommended to confirm the clinical utility of the proposed models.
