The contemporary role and impact of urine-based biomarkers in bladder cancer

Caires

et al. 2020

Cancers

Extracellular vesicles (EVs) are small membrane vesicles released by all cells and involved in intercellular communication. Importantly, EVs cargo includes nucleic acids, lipids, and proteins constantly transferred between different cell types, contributing to autocrine and paracrine signaling. In recent years, they have been shown to play vital roles, not only in normal biological functions, but also in pathological conditions, such as cancer. In the multistep process of cancer progression, EVs act at different levels, from stimulation of neoplastic transformation, proliferation, promotion of angiogenesis, migration, invasion, and formation of metastatic niches in distant organs, to immune escape and therapy resistance. Moreover, as products of their parental cells, reflecting their genetic signatures and phenotypes, EVs hold great promise as diagnostic and prognostic biomarkers. Importantly, their potential to overcome the current limitations or the present diagnostic procedures has created interest in bladder cancer (BCa). Indeed, cystoscopy is an invasive and costly technique, whereas cytology has poor sensitivity for early staged and low-grade disease. Several urine-based biomarkers for BCa were found to overcome these limitations. Here, we review their potential advantages and downfalls. In addition, recent literature on the potential of EVs to improve BCa management was reviewed and discussed.

Section: Liquid Biopsy As a Source Of Biomarkers For Bladder Cancementioning

confidence: 99%

Urinary Biomarkers in Bladder Cancer: Where Do We Stand and Potential Role of Extracellular Vesicles

Caires

et al. 2020

Cancers

“…Metabolites and epigenetic molecules as biomarkers are able to record and monitor the stage of the disease in real time and predict prognosis, recurrence or progression, as well as the evaluation of response to treatment and resistance. However, to demonstrate the reliability of a biomarker and the positive impact, a reliable prospective validation is unavoidably required, in addition to the need for large studies with long follow-up periods and large cohorts of patients [ 13 , 256 , 257 ]. Thus, in BC, these monitoring systems could be used as a new approach to achieve unequivocal diagnoses and minimize the invasiveness of the tests within its handling and management framework.…”

Section: Therapeutic Opportunities and Future Perspectivesmentioning

confidence: 99%

Epigenomic and Metabolomic Integration Reveals Dynamic Metabolic Regulation in Bladder Cancer

Loras

Segovia

Ruiz-Cerdá

2021

Cancers

Bladder cancer (BC) represents a clinical, social, and economic challenge due to tumor-intrinsic characteristics, limitations of diagnostic techniques and a lack of personalized treatments. In the last decade, the use of liquid biopsy has grown as a non-invasive approach to characterize tumors. Moreover, the emergence of omics has increased our knowledge of cancer biology and identified critical BC biomarkers. The rewiring between epigenetics and metabolism has been closely linked to tumor phenotype. Chromatin remodelers interact with each other to control gene silencing in BC, but also with stress-inducible factors or oncogenic signaling cascades to regulate metabolic reprogramming towards glycolysis, the pentose phosphate pathway, and lipogenesis. Concurrently, one-carbon metabolism supplies methyl groups to histone and DNA methyltransferases, leading to the hypermethylation and silencing of suppressor genes in BC. Conversely, α-KG and acetyl-CoA enhance the activity of histone demethylases and acetyl transferases, increasing gene expression, while succinate and fumarate have an inhibitory role. This review is the first to analyze the interplay between epigenome, metabolome and cell signaling pathways in BC, and shows how their regulation contributes to tumor development and progression. Moreover, it summarizes non-invasive biomarkers that could be applied in clinical practice to improve diagnosis, monitoring, prognosis and the therapeutic options in BC.

“…The BTA stat and BTA TRAK tests detect the human complement factor H and complement factor H-related proteins that are involved in cancer cell growth and evasion of the host immune system; these levels increase during the invasion of BC cells (21)(22)(23). The sensitivity and specificity of BTA stat are 57-83% and 60-92%, respectively, while those of BTA TRAK are 73-77% and 45-81%, respectively (6,24,25).…”

Section: Bladder Tumor Antigen (Bta) Stat and Bta Trak (Polymedco Inc Cortlandt Ny Usa)mentioning

confidence: 99%

Review of non-invasive urinary biomarkers in bladder cancer

Lee¹,

Kim²

2020

Transl Cancer Res TCR

Bladder cancer (BC) is the sixth-most prevalent cancer. The standard diagnostic tool of BC is cystoscopy, whereas cystoscopy has several disadvantages in terms of symptomatic invasiveness and operatordependency. The urinary markers are attractive because the testing is non-invasive and cost-efficient, and sample collection is easy. Urinary marker is thereby a good tool to detect exfoliated tumor cell in the urine samples for the diagnosis and therapeutic surveillance of BC to supplement the limitations of the cystoscopy. However, they are not recommended as a population-based screening tool because of the low rate of BC prevalence. Although both cystoscopy and urine cytology improve BC diagnostic power, the field still needs additional non-invasive, cost-effective, and highly sensitive and specific diagnostic tools. Various urinary markers with different mechanisms and different targets have been developed and under investigation in these days. However, the accuracy of the urinary marker including its sensitivity and specificity is the most important factor for the diagnosis and surveillance in cancer that this review deals with multiple FDAapproved and non-FDA approved commercialized urinary markers with their accuracy in different purposes for BC. We then discuss more about the potential candidate targets for the future urinary markers in BC