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An Orthotopic Bladder Tumor Model and the Evaluation of Intravesical saRNA Treatment
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Exploration of the Tumor Transcriptomic and Immune Landscape Following Repeated Transurethral Resection in
Jiwoo Seo1, Jin-Mo Park2, Dong Jin Park3
1Department of Immunology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea; Brain Korea 21 FOUR Program, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
Clinical Genitourinary Cancer
|February 22, 2026
Summary
Repeated transurethral resection of bladder tumor (TURBT) surgery alters molecular, immune, and microbial profiles in nonmuscle-invasive bladder cancer (NMIBC). These changes suggest surgical history impacts tumor characteristics, warranting further study.
Area of Science:
- Urology
- Oncology
- Immunology
- Microbiome Research
Background:
- Nonmuscle-invasive bladder cancer (NMIBC) management often involves transurethral resection of bladder tumor (TURBT) and Bacillus Calmette-Guérin (BCG) therapy.
- Understanding the impact of repeated interventions on the tumor microenvironment is crucial for optimizing NMIBC treatment strategies.
Purpose of the Study:
- To investigate how repeated TURBT and BCG treatment influence the molecular, immunological, and microbial landscapes of NMIBC.
- To identify potential associations between surgical history and tumor characteristics.
Main Methods:
- Analysis of tumor and normal tissues from 24 NMIBC patients undergoing primary or repeated TURBT using RNA sequencing.
- Characterization of the urinary microbiome via 16S rRNA sequencing.
- Stratification of patients based on BCG treatment status.
Main Results:
- Repeated TURBT correlated with significant transcriptomic reprogramming, immune remodeling, and altered urinary microbiome profiles compared to primary TURBT.
- Repeated tumors showed a shift towards cell cycle programs and partial restoration of T and B cell receptor diversity.
- BCG treatment enhanced innate immune responses (dendritic cell activation) but did not affect adaptive immune repertoires.
- Urinary microbiome analysis revealed increased heterogeneity, with specific bacterial taxa found exclusively in patients with repeated TURBT and no BCG treatment.
Conclusions:
- Repeated TURBT is associated with coordinated changes in transcriptomic, immunologic, and microbial features in NMIBC.
- These findings suggest that surgical history may influence molecular and immune characteristics of NMIBC.
- Further longitudinal studies with larger cohorts are needed to validate these preliminary observations.
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