Aarhus, Denmark (UroToday.com) Dr. RY Zhang from Shanghai Jiao Tong University in Shanghai performed molecular subtyping on a cohort of 363 patients with muscle invasive bladder cancer, in an effort to identify the predictive value of subtyping on neoadjuvant chemotherapy (NAC) followed by radical cystectomy.

Dr. Zhang reported that an institution-specific CIT-basal subtype fared worse relative to the CIT-luminal subtype, with CIT-luminal patients enjoying an overall survival benefit following receipt of NAC. Overall survival (OS) improvements were not seen in the basal subtype. ERBB2, FGFR3, and PIK3CA were found to be altered in the NAC responders. The conclusion that luminal subtypes benefited more from MIBC is in contradistinction to previous publications that have actually suggested the opposite;1 it is not clear if this discordance is due to variations in subtyping clustering/definitions or if the tumors are simply being characterized at a different point in their clonal evolution.

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Abstract take home message:

  • There continues to be discordant data and ongoing debate regarding which molecular subtypes, if any, benefit from neoadjuvant chemotherapy, and whether molecular subtyping can be used to effectively prognosticate therapy for these patients

Presented by: RY Zhang, PhD, Shanghai Jiao Tong University, Shanghai  

Written by Dr. Vikram M. Narayan (@VikramNarayan), Urologic Oncology Fellow with Ashish M. Kamat, MD (@UroDocAsh), Professor, Department of Urology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX at the 17th meeting of the International Bladder Cancer Network, (IBCN, #IBCN2019) October 3rd – 5th, 2019 in Aarhus, Denmark.

Reference:
1. Seiler R, Ashab HAD, Erho N, et al. Impact of Molecular Subtypes in Muscle-invasive Bladder Cancer on Predicting Response and Survival after Neoadjuvant Chemotherapy. Eur Urol. 2017;72(4):544-554. doi:10.1016/j.eururo.2017.03.030

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