Potential Impact of the Cancer Genome Atlas for Patients With MIBC

Guru P. Sonpavde, MD, the GU oncology director at the Advent Health Cancer Institute in Orlando, Florida, discusses The Cancer Genome Atlas and key takeaways for community oncologists.

According to data presented at 2023 American Society of Clinical Oncology Genitourinary Cancers Symposium, recurrence is suboptimally associated with the pathologic stage in patients with muscle invasive-bladder cancer (MIBC) following radical cystectomy. As a result, experts created the Cancer Genome Atlas, a prognostic model using information from comprehensive genomic and transcriptomic data from germline and tumor tissues. The hopes of the Cancer Genome Atlas was to improve on the selection of high-risk patients for adjuvant therapy and tailored surveillance.

Investigators evaluated data from a cohort of 117 patients with MIBC to predict 5-year survival, including 39 survivors that satisfied inclusion criteria, and 78 dead patients that were propensity matched against them. What they found was that there was a large germline component when predicting survival. Additionally, the algorithm was 97% accurate on the 38 training samples included, and 94% accurate across the 79 evaluation samples.

Sonpavde suggests that these results are hypothesis generating and if validated, they will provide a huge advance for patients with MIBC.

Transcription:

0:08 | These results are from the deep learning analysis or hypothesis generating. We are trying to validate this in a large prospective trial data set as we speak. I'm hoping we validated this, and if we do, I think that this would be a huge advance, in my opinion, because you can predict this based on an analysis of molecular data that's already there by applying the deep learning analysis without having to do other expensive assays.

0:43 | Selecting patients for adjuvant therapy appropriately is really important, because as we know, approximately half the patients would not even recur, they're not destined to recur. Given a patients, and immune checkpoint inhibitor, for instance, exposing them to significant immune events, some of these immune events are serious, life threatening, and some of them are lifelong and need lifelong therapy, so really, this would have huge benefits to patients and society in general.