Use of Fluorescence In Situ Hybridization to Predict Response to Bacillus Calmette-Guérin Therapy for Bladder Cancer: Results of a Prospective Trial
| Autor: | Rian J. Dickstein, Fabrizio Messetti, Abha Khanna, H. Barton Grossman, Colin P.N. Dinney, Shanna Pretzsch, Graciela Noguera Gonzalez, Tanweer M. Zaidi, Ruth L. Katz, Xifeng Wu, Roosevelt Anderson, Ashish M. Kamat |
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| Rok vydání: | 2012 |
| Předmět: |
Male
Oncology medicine.medical_specialty Pathology Urology medicine.medical_treatment Kaplan-Meier Estimate In situ hybridization Article Adjuvants Immunologic Predictive Value of Tests Internal medicine medicine Humans Prospective Studies Prospective cohort study In Situ Hybridization Fluorescence Aged Bladder cancer medicine.diagnostic_test business.industry Carcinoma in situ Immunotherapy medicine.disease Clinical trial Administration Intravesical Treatment Outcome Urinary Bladder Neoplasms BCG Vaccine Disease Progression Female Neoplasm Recurrence Local business BCG vaccine Fluorescence in situ hybridization |
| Zdroj: | Journal of Urology. 187:862-867 |
| ISSN: | 1527-3792 0022-5347 |
| Popis: | No reliable methods currently exist to predict patient response to intravesical immunotherapy with bacillus Calmette-Guérin given after transurethral resection for high risk nonmuscle invasive bladder cancer. We initiated a prospective clinical trial to determine whether fluorescence in situ hybridization results during bacillus Calmette-Guérin immunotherapy can predict therapy failure.Candidates for standard of care bacillus Calmette-Guérin were offered participation in a clinical trial. Fluorescence in situ hybridization was performed before bacillus Calmette-Guérin, and at 6 weeks, 3 months and 6 months during bacillus Calmette-Guérin therapy with maintenance. Cox proportional hazards regression was used to assess the relationship between fluorescence in situ hybridization results and tumor recurrence or progression. The Kaplan-Meier product limit method was used to estimate recurrence-free and progression-free survival.A total of 126 patients participated in the study. At a median followup of 24 months 31% of patients had recurrent tumors and 14% experienced disease progression. Patients who had positive fluorescence in situ hybridization results during bacillus Calmette-Guérin therapy were 3 to 5 times more likely than those who had negative fluorescence in situ hybridization results to experience recurrent tumors and 5 to 13 times more likely to have disease progression (p0.01). The timing of positive fluorescence in situ hybridization results also affected outcomes. For example, patients with a negative fluorescence in situ hybridization result at baseline, 6 weeks and 3 months demonstrated an 8.3% recurrence rate compared to 48.1% for those with a positive result at all 3 points.Fluorescence in situ hybridization results can identify patients at risk for tumor recurrence and progression during bacillus Calmette-Guérin immunotherapy. This information may be used to counsel patients about alternative treatment strategies. |
| Databáze: | OpenAIRE |
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