BCANTT 2020: High-Risk Non-Muscle Invasive BCG Unresponsive Bladder Cancer: Molecular Subtypes

(UroToday.com) Woonyoung Choi, PhD, from the Johns Hopkins Greenberg Bladder Cancer Institute, presented on the association of molecular subtypes and Bacillus Calmette-Guerin (BCG) responses. She used the consensus subtype classification (CSC) and found no association between responders/no responders using the CSC.

Using the MDA classification, they found nonresponders had more fibroblast enrichment and two resistance mechanisms. Inflamed, excluded and desert immune phenotypes may respond to different targeted agents. Responders were noted to be CD8 activated, while non-responders were immune desert or immune excluded subtypes. B cell lymphocytes may be important with TGF beta attenuating tumor response to PDL1 blockade. BCG induced an immune response in immune desert subtype along with TGF beta and fibroblast signature. In conclusion, she found two immunogenic subtypes in BCG unresponsive tumors with further investigations underway.

Presented by: Woonyoung Choi, PhD, John Hopkins, Johns Hopkins Greenberg Bladder Cancer Institute, Baltimore, Maryland 

Written by: Stephen B. Williams, MD, Medical Director for High-Value Care; Chief of Urology, Professor, Director of Urologic Oncology, Director Urologic Research, The University of Texas Medical Branch at Galveston, TX at the 2020 Virtual Bladder Cancer Advocacy Network Think Tank 2020

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