Gene Profile Predicts Risk of Bladder Cancer Recurrence

A genomic study has pinpointed several markers that identify bladder cancer patients at risk of recurrence and that may be indicators of overall survival status.

Nearly half of patients with bladder cancer experience recurrences, so reliable predictors of this recurrent phenotype are needed to guide surveillance and treatment. To identify genetic variants that modify bladder cancer prognosis, investigators at Dartmouth Medical School (Lebanon, NH, USA) focused on genes involved in major biological carcinogenesis processes (apoptosis, proliferation, DNA repair, hormone regulation, immune surveillance, and cellular metabolism).

The investigators analyzed genes from 563 bladder cancer patients to identify genetic variants that modify time to bladder cancer recurrence and patient survival. Patients were followed for a median of 5.4 years during which about half of them experienced at least one recurrence.

Results revealed that those patients with variants in the ALDH2 (aldehyde dehydrogenase 2) gene, which encodes an enzyme involved in alcohol metabolism, were likely to experience bladder cancer recurrence shortly after treatment. Time to recurrence was also shorter for patients who had a variant in the VCAM1 (vascular cellular adhesion molecule 1) gene, which encodes a glycoprotein involved in the development of lymphoid tissues, and were treated with immunotherapy. Patients who had noninvasive tumors and a variant in the DNA repair gene XRCC4 tended to live longer than patients who did not have the variant.

“The genetic markers that we found could potentially be useful for individually tailoring surveillance and treatment of bladder cancer patients,” said first author Dr. Angeline S. Andrew, assistant professor of community and family medicine at Dartmouth Medical School.

The study that identified biomarkers linked to bladder cancer recurrence was published in the March 26, 2014, online edition of the journal BJU International.

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