Bladder cancer is the sixth most commonly diagnosed cancer in the European Union. Here, we evaluate the performance of a novel, commercially available enzyme-linked immunosorbent assay utilising MCM5 antibodies (ADXBLADDER; Arquer Diagnostics Ltd, Sunderland, UK) for the detection of bladder cancer, in a blinded, prospective study of 856 patients, across seven centres, presenting with haematuria. The results were compared with the patients’ clinical data and final diagnosis as defined by the results of the imaging and cystoscopy, with a prevalence of bladder cancer of 8.6%. ADXBLADDER detected bladder tumours in 54/74 cancers, giving overall sensitivity of 73.0% and an overall negative predictive value (NPV) of 96.4%. Sensitivity and NPV of ADXBLADDER were highest in muscle-invasive bladder cancer, both at 100%, and on analysis of non-pTa (pT1 and above) tumours, the sensitivity for detection was 97% with an NPV of 99.8%. A subset of 173 patients had matching cytology data; of these patients, 18 were positive for bladder cancer. ADXBLADDER detected 16/18 of these cancers, whilst cytology was positive in only four of 18, providing evidence that ADXBLADDER may be a more sensitive test for bladder cancer than standard urine cytology. PATIENT SUMMARY: We conducted a large clinical study of a novel, simple urine test (ADXBLADDER), which measures a protein (MCM5) in urine and can be used to detect bladder cancer in patients. We recruited 856 patients and demonstrated that the new urine test can detect bladder cancer with a high degree of accuracy, performing better than the most commonly used urine test-urine cytology. In conclusion, this novel ADXBLADDER urine test can be used to help detect bladder cancers and it can replace the current, standard urine test.

European urology oncology. 2019 Jul 12 [Epub ahead of print]

Tim Dudderidge, Jacqui Stockley, Ghulam Nabi, Jaswant Mom, Nkemi Umez-Eronini, David Hrouda, Jo Cresswell, Stuart Robert Crozier McCracken

Dept. of Urology, University Hospital Southampton NHS Foundation Trust, Southampton, UK., Arquer Diagnostics Ltd, R&D, Sunderland, UK., Dept. of Urology, Ninewells Hospital, Dundee, UK., Dept. of Urology, West Cumberland Hospital, Whitehaven, UK., Dept. of Urology, The Cumberland Infirmary, Carlisle, UK., Dept. of Urology, Charing Cross Hospital, London, UK., Dept. of Urology, The James Cook University Hospital, Middlesbrough, UK., Dept. of Urology, Sunderland Royal Hospital, Sunderland, UK. Electronic address: .