Urinary Biomarkers in Childhood Cancer Survivors with Lower Urinary Tract Dysfunction

Area of Science:

• Oncology
• Urology
• Biomarker Discovery

Background:

• Childhood cancer survivors (CCS) face increased risk of therapy-related lower urinary tract dysfunction (LUTD).
• Pelvic external beam radiation therapy (EBRT) and chemotherapy are known risk factors for LUTD in CCS.
• Current screening methods for LUTD in CCS have limitations.

Purpose of the Study:

• To evaluate specific urinary biomarkers as a potential screening tool for LUTD in CCS.
• To assess the association between urinary biomarkers and prior pelvic EBRT or chemotherapy exposure.
• To determine the diagnostic performance of urinary biomarkers in identifying LUTD in CCS.

Main Methods:

• Prospective cohort study of CCS with collection of first morning urine samples.
• Analysis of urinary biomarkers including adenosine triphosphate (ATP), nerve growth factor (NGF), proNGF, brain-derived neurotrophic factor (BDNF), and creatinine.
• Correlation of biomarker levels with non-invasive urodynamic study (niUDS) outcomes and radiation exposure, using logistic regression and ROC analyses.

Main Results:

• Urinary biomarker levels showed minimal differences between survivors with and without pelvic EBRT.
• No significant association was found between any evaluated biomarker and abnormal uroflow or LUTD.
• Receiver operating characteristic (ROC) analysis indicated poor discriminatory performance for all tested biomarkers.

Conclusions:

• The evaluated urinary biomarkers are not reliable for screening LUTD in CCS.
• No significant association was found between these biomarkers and prior pelvic EBRT.
• Development of novel objective biomarkers and screening strategies is crucial for early LUTD detection in pediatric cancer survivors.