ASCO GU 2020: Current Developments in Rare Urologic Malignancies: Are Biomarkers Going to Change the Future of Testicular Cancer?

San Francisco, California (UroToday.com) The sharp improvement in the prognosis of testicular cancer since the last 1970s represents a success story in the history of medical oncology. With new chemotherapies, treatment shifts from the end of life palliation to curative intent. With that came a need to optimize survivorship and focus our efforts on prolonging not just life but quality of life. At the center of that goal, is the need to limit treatment to those who will benefit and spare those for whom the treatments would be ineffective. To that end, Dr. Lucia Nappi was invited to discuss the potential role of biomarkers within this disease state.

She focused her talk on micro-RNA biomarker targets, Specifically mi 371, 302, and 367. They are expressed in >90% of GCT, correlate with the clinical stage and disappear with successful treatment. Additionally, they are specific for GCT, but for that reason are not expressed by teratoma. She reviewed a number of positive studies that evaluated miRNA expression in a variety of clinical settings, as outlined in the table below.

ASCOGU_micro-RNA.png

Dr. Nappi continued her talk by highlighting her own groups work specifically looking at miR371. They have demonstrated previously that it outperforms CT scans and traditional biomarkers in the detection of viable GCT.

ASCOGU_miR371.png

For this reason, the S1823 trial will be launched to validate the clinical utility of miR371 in a prospective observational cohort. The primary endpoint of the study is to establish the positive predictive value of miR371 in active germ cell malignancy in early stage germ cell tumor patients. The hope is that this information could be used to help guide, adjuvant treatment for high risk clinical stage I patients and to select patients for RPLND in the post chemotherapy setting.

Concluding the talk, Dr. Nappi highlighted the potential usefulness of mRNA as a biomarker in GCT and the multiple scenarios in which this information could be utilized. In the future, the results of her trial and other similar are necessary to validate their clinical utility to establish the role of miRNA as a useful biomarker.

Presented by: Lucia Nappi, MD, PhD, Medical Oncologist and Senior Research Scientist, BC Cancer Agency, British Columbia, Canada

Written by: Adrien Bernstein, MD, Society of Urologic Oncology Fellow, Fox Chase Cancer Center, Fox Chase Cancer Center, Philadelphia, PA  at the 2020 Genitourinary Cancers Symposium, ASCO GU #GU20, February 13-15, 2020, San Francisco, California

email news signup