PMID- 25171275
OWN - NLM
STAT- MEDLINE
DCOM- 20150817
LR  - 20151119
IS  - 1195-9479 (Print)
IS  - 1195-9479 (Linking)
VI  - 21
IP  - 4
DP  - 2014 Aug
TI  - Biomarkers in patients treated with BCG: an update.
PG  - 7335-43
AB  - INTRODUCTION: Bacillus Calmette-Guerin (BCG) instillations are the recommended 
      treatment for non-muscle invasive bladder cancer but high recurrence and 
      progression rates remain after treatment. Despite patients risk stratification, 
      BCG effectiveness remains unpredictable. A close, invasive and expensive follow 
      up is mandatory. To improve or even replace this heavy surveillance in this high 
      risk population, validated biomarkers were developed. MATERIALS AND METHODS: To 
      identify the useful tools for the urologist in monitoring bladder cancer 
      patients, we reviewed the literature focusing on plasma and urinary biomarkers of 
      BCG-therapy outcome. Articles dated from 1988 to 2013 including specific keywords 
      (urinary bladder neoplasm, biological markers, intravesical administration, 
      recurrence) were examined and relevant papers were selected. RESULTS: Before 
      treatment initiation, genetic polymorphisms of multiple agents (cytokines, 
      matrix-metalloproteinases) were found to become very useful to tailor therapy and 
      monitoring. Those biomarkers belong to personalized medicine which is a topic of 
      great interest today, but still need to be validated in cohorts from different 
      ethnicities. During instillations, cytokines (IL-2, IL-8, IL-6/IL-10) were 
      reported to be reliable to determine treatment response and efficacy. Further 
      studies are needed to confirm results and standardize thresholds. After 
      treatment, UroVysion, the FDA-approved fluorescence in situ hybridization (FISH), 
      appeared to be the most robust marker of all the clinical parameters reviewed; 
      but is not yet validated for BCG-treated patients. CONCLUSIONS: No 
      recommendations for everyday practice can be established today, but a combination 
      of several markers and clinicopathological characteristics may be the future. As 
      bladder cancer diagnosis and management are evolving, practicing urologists 
      should be aware of and utilize bladder cancer markers in clinical practice.
FAU - Klap, Julia
AU  - Klap J
AD  - Harvard Medical School, Boston, Massachusetts, USA.
FAU - Schmid, Marianne
AU  - Schmid M
FAU - Loughlin, Kevin R
AU  - Loughlin KR
LA  - eng
PT  - Journal Article
PT  - Review
PL  - Canada
TA  - Can J Urol
JT  - The Canadian journal of urology
JID - 9515842
RN  - 0 (BCG Vaccine)
RN  - 0 (Biomarkers, Tumor)
SB  - IM
MH  - Administration, Intravesical
MH  - BCG Vaccine/administration & dosage/*therapeutic use
MH  - Biomarkers, Tumor/*blood/*urine
MH  - Disease Progression
MH  - Humans
MH  - Neoplasm Recurrence, Local
MH  - Treatment Outcome
MH  - Urinary Bladder Neoplasms/blood/*drug therapy/urine
EDAT- 2014/08/30 06:00
MHDA- 2015/08/19 06:00
CRDT- 2014/08/30 06:00
PHST- 2014/08/30 06:00 [entrez]
PHST- 2014/08/30 06:00 [pubmed]
PHST- 2015/08/19 06:00 [medline]
PST - ppublish
SO  - Can J Urol. 2014 Aug;21(4):7335-43.