Endothelin-1 indicates unfavorable prognosis in primary high-grade non-muscle-invasive urothelial bladder cancer

Mitrakas, Lampros; Gravas, Stavros; Karasavvidou, Foteini; Zachos, Ioannis; Karatzas, Anastasios; Oeconomou, Athanasios; Koukoulis, Georgios; Tzortzis, Vassilios; Papandreou, Christos N.

doi:10.4081/aiua.2021.2.143

Cited by 3 publications

(4 citation statements)

References 17 publications

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“…Immunohistochemical staining for ET-1 was assessed. Study showed that ET-1 associates significantly with recurrence (p = 0.000), progression (p = 0.000), RFS (p = 0.000) and PFS (p = 0.000), deteriorating the outcome of BCG-treated patients [15].…”

Section: Resultsmentioning

confidence: 99%

Factors Predicting the Outcome of BCG (Bacillus Calmette-Guerin) Therapy

Eidininkas¹,

Simenas²,

Auškalnis³

2022

Health Sciences

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Background: Bacillus Calmette-Guerin is currently considered to be the gold standard in conservative treatment for intermediate and high risk non-muscle invasive bladder cancer (NMIBC). However, up to 40% of the patients, treated with adjuvant BCG therapy, experience failure. As the new methods of treatment after BCG failure appear, there is a need to assess efficacy of this therapy in order to improve appropriate treatment during or before BCG therapy. Aim: To review the latest studies on factors, predicting BCG efficacy, and provide summarized information regarding treatment outcomes in current practice. Methodology: The search was conducted in MEDLINE (Pubmed) and ScienceDirect databases using predetermined keywords: Bacillus Calmette-Guerin (BCG), failure, intravesical therapy, outcome, response, predicting factors, immunological markers, efficacy. 10 articles published since 2017 were included in this literature review. Results: Prognostic factors such as the use of antibiotics prior to the therapy, body mass index (BMI), lymphovascular invasion (LVI), endothelin-1 (ET-1), tumor substaging, CD4/CD8, GATA3/T-bet, CD163/CD68, neutrophil-to-lymphocyte (NLR) ratios are promising factors for estimating the possible response of BCG therapy before undergoing treatment. Blood eosinophil count and percentage, FISH test following 3 months after first BCG instillation and a Cytokine Panel for Response to Intravesical Therapy (CyPRIT) nomogram showed huge potential for predicting BCG outcome during BCG treatment. Conclusion: There are quite many possible clinicopathologic, immunological, immunohistochemical and anamnestical factors that could predict the success of BCG therapy. However, in order to include prognostic factors in treatment guidelines, further studies should be performed to determine which of these factors have the greatest clinical value.

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Section: Resultsmentioning

confidence: 99%

Factors Predicting the Outcome of BCG (Bacillus Calmette-Guerin) Therapy

Eidininkas¹,

Simenas²,

Auškalnis³

2022

Health Sciences

View full text Add to dashboard Cite

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“…Endothelin-1 has been suggested to worsen the prognosis of patients treated with adjuvant BCG installations for primary high-grade non-muscle-invasive urothelial bladder cancer. 25 According to the recent study, patients with high-risk NMIBC who underwent partial and complete induction of BCG experienced similar outcomes. 26 These results are comparable with our findings in continuing or discontinuing the maintenance therapy.…”

Section: Discussionmentioning

confidence: 98%

“…Endothelin-1 has been suggested to worsen the prognosis of patients treated with adjuvant BCG installations for primary high-grade non–muscle-invasive urothelial bladder cancer. 25 …”

Section: Discussionmentioning

confidence: 99%

Evaluating the Effectiveness of Intravesical Instillation of BCG by Modified Maintenance Method in Patients With High-Risk Ta and T1 Bladder Cancer: A Randomized Clinical Trial

Shakhssalim,

Dadpour,

Sharifiaghdas

et al. 2023

Clin Med Insights Oncol

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Background: It is estimated that 75% of urothelial bladder cancers are non–muscle-invasive cancers (NMIBCs). The development of more effective methods for optimizing the management of this subset of patients is of paramount importance. This study aimed to evaluate the effectiveness and side effects of modified maintenance Bacillus Calmette-Guérin (BCG) therapy in patients with high-risk NMIBC. Methods: A total of 84 patients with NMIBC who met the inclusion criteria were randomly divided into 2 groups of 42 patients after receiving intravesical BCG weekly, 1 month after transurethral resection of the bladder tumor (TURT) for 6 weeks as the induction. In group I, patients continued monthly intravesical instillation of BCG for 6 months as maintenance, whereas group II patients did not. All patients were followed up for recurrence and progression for 2 years. Results: Although the recurrence rate was lower in group I (16.7% vs 31%), there was no significant difference among groups (P = .124). Pathology progression was also lower in group I (7.1% vs 11.9%) with no significant difference among groups (P = .713). Complications were not statistically different among groups (P = .651). A statistically significant difference was not observed between the groups in the acceptance rate of patients (97.6% in group I vs 100% in group II). Conclusions: The recurrence rate and progression rate in NMIBC patients with maintenance-free induction therapy after TURT were almost twice as high as those with 6-month maintenance therapy; however, it was not statistically significant. Modified BCG maintenance protocol made favorable compliance for patients. Trial registration: This study was retrospectively registered at Iranian Registery of Clinical Trials with the code IRCT20220302054165N1.

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“…Another tyrosine kinase dysregulation of Axl receptor and its ligand growth arrest specific gene was also studied in urinary bladder carcinoma and showed a close relation to tumor stage and tumor grade, but still further studies are recommended to assess its role in tumor prognosis (15,16). However, there are few reports of C-erbB-2 status in NMIBUC.…”

Section: Discussionmentioning

confidence: 99%

HER2/neu expression status of post BCG recurrent non-muscle-invasive bladder urothelial carcinomas in relation to their primary ones

Ali

Aboelsaad

Gawad

et al. 2023

Arch Ital Urol Androl

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Background: Transurethral resection (TUR) followed by adjuvant therapy is still the treatment of choice of Non-Muscle-Invasive Bladder Urothelial Carcinoma (NMIBUC). However, recurrence is one of the most troublesome features of these lesions. Early second resection and adjuvant BCG therapy has been shown to improve the outcome. Objective: To evaluate the prognostic value of C-erbB-2 (HER2/neu) expression status in Non-Muscle-Invasive Bladder Urothelial Carcinoma cases, before and after intravesical Bacillus Calmette Guerin (BCG immunotherapy). Materials and methods: HER2/neu expression was studied in 120 (Ta-T1) Non-Muscle-Invasive Urothelial Carcinoma cases. The expression was evaluated and compared to the expression after Bacillus Calmette Guerin (BCG) immunotherapy. Results: HER2/neu expression in low and high grade of the Non- Muscle-Invasive Urothelial Carcinoma was (38%) and (83%) respectively. The difference of the expression rates by tumor grade was statistically significant. In recurring lesions post BCG therapy, C-erbB-2 expression was markedly decreased (31.6%) when compared to its expression before therapy (65%). Conclusions: The HER2/neu expression increased as the tumor grade rose. The reduction in expression following BCG treatment in Non-Invasive transitional cell carcinoma cases could reflect a reduction of the potential malignancy of the tumor.

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Endothelin-1 indicates unfavorable prognosis in primary high-grade non-muscle-invasive urothelial bladder cancer

Cited by 3 publications

References 17 publications

Factors Predicting the Outcome of BCG (Bacillus Calmette-Guerin) Therapy

Factors Predicting the Outcome of BCG (Bacillus Calmette-Guerin) Therapy

Evaluating the Effectiveness of Intravesical Instillation of BCG by Modified Maintenance Method in Patients With High-Risk Ta and T1 Bladder Cancer: A Randomized Clinical Trial

HER2/neu expression status of post BCG recurrent non-muscle-invasive bladder urothelial carcinomas in relation to their primary ones

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