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  1. Home
  2. Association Between Proto-oncogene N-ras Transcript Level And Overall Survival In Node-negative Muscle-invasive Bladder Cancer.
  1. Home
  2. Association Between Proto-oncogene N-ras Transcript Level And Overall Survival In Node-negative Muscle-invasive Bladder Cancer.

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Association Between Proto-Oncogene N-RAS Transcript Level and Overall Survival in Node-Negative Muscle-Invasive

Donghyun Kim1, Yasser Ged2, Petros Grivas3

  • 1Division of Hematology, Oncology and Blood & Marrow Transplantation, Department of Internal Medicine, University of Iowa Health Care, Iowa City, IA.

Clinical Genitourinary Cancer
|April 29, 2026

View abstract on PubMed

Summary
This summary is machine-generated.

High N-RAS expression in muscle-invasive bladder cancer (MIBC) correlates with poorer survival. Low N-RAS may indicate a benefit from cisplatin chemotherapy, suggesting N-RAS as a potential prognostic biomarker in MIBC.

Keywords:
CisplatinGene expressionPrognostic biomarkerUrothelial carcinoma of the bladder

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Area of Science:

  • Oncology
  • Genetics
  • Biomarker Discovery

Background:

  • Muscle-invasive bladder cancer (MIBC) treatment advances highlight the need for prognostic biomarkers.
  • While H-RAS and K-RAS mutations are common in bladder cancer, N-RAS mutations are rare, but N-RAS overexpression has been observed.
  • The clinical significance of N-RAS overexpression in MIBC remains unclear.

Purpose of the Study:

  • To investigate the prognostic implications of N-RAS expression in muscle-invasive bladder cancer (MIBC).
  • To explore the association between N-RAS expression levels and patient survival outcomes.
  • To determine if N-RAS expression influences response to cisplatin-based chemotherapy.

Main Methods:

  • Analysis of The Cancer Genome Atlas Bladder Cancer dataset (n=411), focusing on node-negative MIBC (n=218).
  • Stratification of patients into 'high' and 'low' N-RAS transcript expression groups based on the cohort median.
  • Survival analyses, including overall survival, were performed using these stratifications.
  • Main Results:

    • High N-RAS expression was linked to inferior 5-year overall survival in node-negative MIBC (HR 1.91, P=.007).
    • A significant overall survival benefit from cisplatin-based chemotherapy was observed in the low N-RAS group (HR 0.28, P=.019), but not in the high N-RAS group.
    • The high N-RAS group exhibited significantly higher CD274 (PD-L1) transcript levels compared to the low N-RAS group (P < .0001).

    Conclusions:

    • N-RAS transcript levels may serve as a prognostic indicator for node-negative MIBC.
    • Lower N-RAS expression levels could be associated with improved survival outcomes when treated with cisplatin-based chemotherapy.
    • N-RAS expression warrants further investigation as a predictive biomarker in MIBC treatment strategies.