ANAHEIM, CA (UroToday.com) - This session dealt with multiple investigations in basic and translational aspects of bladder cancer. Anai and associates reported on the administration of liposomal doxorubicin particles in a mouse model of bladder cancer [ABST 882]. Several control settings were employed including convential doxorubicin administration. In those cohorts receiving the lipsomal doxorubicin preparation, a 50% or greater reduction in the number of tumors was noted as was a significant decrease in tumor size. The data suggest a rationale for studies beyond this preclinical model Mycobacterial cell wall-DNA complex (MCC) was evaluated with active and inactive BCG with regard to antiproliferative activity in bladder cancer cell linesby Phillips and associates [ABST 883]. Under different conditions MCC demonstrated optimal anticancer activity in 3-48 hrs of exposure. The effectiveness of live or autoclaved BCG was significantly less with regard to cell proliferation (p<0.05) and required 7 day exposure to reach optimization. The MCC demonstrated antiproliferative activity in the absence of non-specific cytotoxicity and suggests that its anticancer activity may be distinct to that of BCG.

Feldman and colleagues described the identification of cystatin B as a potential biomarker of bladder cancer [ABST 887]. Patient urine specimens were analyized by 2D PAGE gels and liquid chromatography as well as mass spectroscopy. Urinary cystatin B emerged as a candidate and was evaluated in a cohort of patient samples after standardization of cut off values. Those patients with elevated cystatin B values with tumor stage and elevated risks of tumor recurrence. Immunostaining of tissue deomostrates minimal staining in normal urothelium and stronger staining in tumors. Further investigations are ongoing to determine the value of this novel finding as a potential tumor marker.

Kramer and associates reported on further evaluation on the usefulness of hyaluronic acid and hyal1 hyaluronidase as predictors of bladder cancer prognosis [ABST 890]. This was not a urine marker test but an immunohistochemical evaluation of 179 bladder cancer specimens in patients with 3 years follow up. Staining for both agents was greater in muscle invasive than non invasive specimens. By combining the staining index of both substances, the staining inferences had 81% sensitivity and 70% specificity to predict disease progression. High combined staining had a 10 fold odds ratio for progression. Combined staining also demonstrated a 82% sensitivity and 65% specificity for predicting treatment failure.

The meaning of persistent uroplakin expression in bladder cancer was evaluated in a tissue microarray of over 300 specimens to correlate these findings with clinical outcome [ABST 892]. Huang and associates noted that UPs were detected in all normal urothelial, 85% of superficial lesions and 48% of muscle invasive lesions as well as 66 % of lymph node metastases. In superficial lesions there was no correlation between UP expression and clinical outcomes yet in muscle invasive disease the lack of up expression was associated with advanced stage, positive lymph node expression and cancer-specific mortality these results suggest that UP expression is associated with favorable prognosis in patients with invasive disease.

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Written by S.Bruce Malkowicz, MD, a Contributing Editor with UroToday.

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