Measurement of urinary protein can help detect recurrent bladder cancer

January 17, 2006

Measurement of a certain protein in urine can increase the ability to detect bladder cancer recurrence, with test results available during the patient's visit, according to a study in the January 18 issue of JAMA.

Bladder cancer is the fifth most common malignancy in the United States, according to background information in the article. In 2005, there were an estimated 63,210 new cases and more than 13,000 deaths. There are 500,000 patients in the United States with a history of bladder cancer, making its prevalence higher than that of lung cancer. The probability of recurrence ranges from 50 percent to 90 percent, depending on stage, grade, and number of primary tumors. Consequently, rigorous surveillance is advocated. A combination of methods is used to monitor patients at risk of recurrent bladder cancer because no single procedure is 100 percent sensitive. Cystoscopy (visual examination of the bladder with a medical instrument) is a standard approach but can fail to detect some bladder cancers. Cytologic (cell) analysis of urine frequently is used as an adjunctive test, but can have poor sensitivity and variability in interpreting results.

H. Barton Grossman, M.D., of the M. D. Anderson Cancer Center, Houston, and colleagues investigated the clinical utility of a noninvasive urine test, which can be used in the physician's office, for the protein NMP22, as an aid in detecting recurrent cancer in patients with a history of bladder cancer. The researchers compared its usefulness with that of voided urine cytology, which must be analyzed in a clinical laboratory. The study, conducted from September 2001 to February 2002, included 23 academic, private practice, and hospital facilities in 9 U.S. states and enrolled 668 patients with a history of bladder cancer. Prior to undergoing cystoscopy, patients provided a urine sample for analysis of NMP22 protein and for cytology testing.

Bladder cancer was diagnosed in 103 patients. Cystoscopy alone identified 91.3 percent of the cancers. The combination of cystoscopy with the NMP22 assay detected 99.0 percent of the malignancies. The NMP22 assay detected 8 of 9 cancers that were not visualized during initial cystoscopy, including 7 that were high-grade. The sensitivity and specificity of the NMP22 test alone were 49.5 percent and 87.3 percent, respectively. Cytology based on voided urine detected only 3 of the malignancies missed during initial cystoscopy and did not significantly increase the sensitivity of cystoscopy (94.2 percent).

The authors conclude, "When combined with cystoscopy, the NMP22 test improves the detection of recurrence in patients with a history of bladder cancer."
-end-
(JAMA. 2006;295:299-305. Available pre-embargo to the media at www.jamamedia.org)

Editor's Note: Matritech Inc., supplied the experimental assay to the investigators at no cost and reimbursed clinical sites for the time involved in collection of data related to FDA submission. This included risk factors, demographic information, and test results. Co-author Dr. Katz had travel expenses to a meeting reimbursed by Matritech Inc. No other authors reported disclosures.

The JAMA Network Journals

Related Bladder Cancer Articles from Brightsurf:

Effectiveness of gemcitabine & daily RT for bladder preservation in muscle-invasive bladder cancer
Bladder preservation with trimodality therapy can be a safe and effective alternative to cystectomy for selected patients with muscle-invasive bladder cancer.

Anthrax may be the next tool in the fight against bladder cancer
Researchers at Purdue University have come up with a way to combine the anthrax toxin with a growth factor to kill bladder cancer cells and tumors.

Effectiveness of a new bladder cancer treatment demonstrated
Demonstrated the effectiveness of a drug for treating metastatic bladder cancer in patients who did not respond to the usual treatment.

Lifting the lid on bladder cancer support
Bladder cancer is a painful and sometimes life-threatening condition that patients can find difficult to talk about, with many becoming homebound as they cope with debilitating side effects such as incontinence.

How genomics profiling can help identify the best treatment for bladder cancer
A new computational tool -- a single-patient classifier -- effectively enables physicians to assign a bladder cancer subtype to an individual patient's cancer using that patient's genomic data.

Early menopause in smokers linked to bladder cancer
Research shows that experiencing menopause before the age of 45 is associated with a higher risk of bladder cancer.

Olfactory receptor as therapeutic target in bladder cancer
Researchers from Bochum have detected an olfactory receptor in the human bladder that might prove useful for bladder cancer therapy and diagnosis.

Bladder cancer model could pave the way for better drug efficacy studies
In the journal Cancer Research, UNC Lineberger Comprehensive Cancer Center researchers report they have developed a model of luminal bladder cancer, one of the two subtypes of advanced bladder cancer.

Genetic fixer-uppers may help predict bladder cancer prognosis
Mutations in genes that help repair damage to DNA may aid in predicting the prognosis of patients with bladder and other related cancers, according to researchers, who found that bladder cancer patients who had mutations in their ATM or RB1 genes -- proteins that help repair DNA damage when they're functioning normally -- tended not to live as long as patients without the mutations.

Simultaneous chemo and immunotherapy may be better for some with metastatic bladder cancer
Researchers from Mount Sinai and Sema4, a health information company and Mount Sinai venture, have discovered that giving metastatic bladder cancer patients simultaneous chemotherapy and immunotherapy is safe and that patients whose tumors have certain genetic mutations may respond particularly well to this combination approach, according to the results of a clinical trial published in European Urology.

Read More: Bladder Cancer News and Bladder Cancer Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.