Qualitative Interferon-γ Release Assay for Predicting Response to BCG Instillations in Bladder Cancer

Area of Science:

• Urology
• Oncology
• Immunology

Background:

• High-risk non-muscle invasive bladder cancer (NMIBC) necessitates effective treatment strategies.
• Intracavitary Bacillus Calmette-Guerin (BCG) is a standard treatment for NMIBC.
• Predicting BCG response is crucial for optimizing patient management.

Purpose of the Study:

• To evaluate the utility of T-spot testing, specifically culture filtrate protein 10 (CFP-10) positivity, in predicting BCG treatment response in high-risk NMIBC patients.
• To identify potential biomarkers for BCG immunotherapy efficacy.

Main Methods:

• Retrospective identification and prospective T-spot testing of high-risk NMIBC patients.
• Classification of patients into BCG-unresponsive (study group) and BCG-responsive (control group) based on recurrence and follow-up.
• Analysis of T-spot positivity and CFP-10 positivity rates between groups.

Main Results:

• In a cohort of 42 high-risk NMIBC patients, 40% were unresponsive to BCG.
• CFP-10 positivity was significantly higher in BCG-unresponsive patients (91.7%) compared to the responsive control group (35.7%; p=0.004).
• T-spot positivity showed a trend but did not reach statistical significance in predicting BCG response (p=0.235).

Conclusions:

• CFP-10 positivity, detected by T-spot testing, shows promise as a predictive marker for BCG treatment response in NMIBC.
• This biomarker could aid in personalizing NMIBC treatment strategies.
• Further research is warranted to validate CFP-10 as a predictive tool for BCG immunotherapy.