Abstract 101P
Background
The heterogeneity of bladder cancer is defined by molecular subtyping, which aims to provide better risk stratification. This study investigated the association between survival analysis of non-muscle invasive bladder cancer (NMIBC) patients' molecular subtypes and the efficacy of intravesical Bacillus Calmette-Guérin therapy (BCG).
Methods
A total of 107 BCG non-responsive patients were enrolled with stage Ta high grade and/or T1 low and high grade. The patients were classified in luminal subtype marked by GATA3, CK20, and Uroplakin II and basal subtype; CK5/6 and CD44.The univariate and multivariate survival analyses were used to identify the association with clinicopathological parameters and molecular subtypes.
Results
In NMIBC, the relative expression of luminal markers defines subtype class 2 and basal markers define subtype class 3, whereas class 1 showed no relative expression of basal and luminal markers. The molecular subtype is an independent risk factor for recurrence-free survival (RFS) (P = 0.041) and progression-free survival (PFS) (P = 0.044) with high-grade and tumor-stage T1 in NMIBC. The molecular class shows a significant difference in the RFS (P =0.036) and PFS(P =0.019) of the BCG-non-responsive patients.
Conclusions
The significance of molecular subtyping in predicting the efficacy of intravesical BCG therapy in NMIBC classes 2 and 3 showed independent correlations with RFS, whereas class 3 had PFS. These findings highlight the potential of immune histochemistry-based classification to aid risk stratification and support comprehensive pathological evaluation to improve the diagnosis and management of basal-like bladder cancer.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Indian Council of Medical Research.
Disclosure
All authors have declared no conflicts of interest.