UR Urologists Study New DNA Test for Bladder Cancer Recurrence
Wilmot Cancer Center Leading Upstate Arm of National Research Study
Thursday, October 07, 2004
Edward Messing, M.D.,
James P. Wilmot Cancer Center urologists are joining a national effort to test a new detection method for the recurrence of bladder cancer – one of the most common forms of cancer to return after treatment.
The Wilmot Cancer Center is one of 12 sites across the nation selected by the National Cancer Institute to validate a new test to detect a marker for bladder cancer. Urologist Edward M. Messing, M.D., is leading the local three-year study, which will examine genetic changes in DNA obtained through urine samples. The test, if successfully validated, will provide a sensitive and non-invasive method of screening for bladder.
“This is the first study of its kind,” says Messing, chair of urology department at the University of Rochester Medical Center. “It's the first study testing high-speed DNA technology to detect bladder cancer. If the results are positive, it will make large use of this test for monitoring this disease, and even screening, feasible.”
Each year, about 60,000 people are diagnosed with bladder cancer, one of the more common cancers and one that has a high recurrence rate.
Frequent surveillance of bladder cancer patients is critical, but current procedures have shortcomings. Urine cytology, which checks the number and appearance of cells in urine samples, often fails to detect early tumors. Cystoscopy -- examining the urethra and bladder with a thin, lighted scope - can miss very early cancer or mistake non-malignant conditions for cancer, giving patients a false-positive result. Cystoscopy is also an invasive and unpleasant test.
The new test, created by the NCI’s Early Detection Research Network, looks to improve upon these weaknesses. EDRN is a broad, interdisciplinary consortium whose work is aimed at both identifying and validating cancer biomarkers for use in early cancer detection.
The bladder cancer test uses a technology known as microsatellite DNA analysis (MSA). Microsatellites, also known as short tandem repeats, are repeating units of one to six nucleotides found throughout human chromosomes. These repeating regions are frequently mutated in tumors. For screening for recurrent bladder cancer, DNA can be easily extracted from cells that are normally present in urine, and compared to DNA sequences of unaffected cells. Early studies have shown this non-invasive analysis can have over 90 percent accuracy.
In the validation study, 15 different biomarkers in 300 patients diagnosed with bladder cancer will be examined in an effort to predict cancer recurrence. Patients with healthy bladders and others with non-cancerous bladder problems that could be misdiagnosed as cancer, such as kidney stones or urinary tract infections, will be used as controls.
Other institutions participating in the study include: University of Alabama-Birmingham, Baylor College of Medicine, University of Chicago Center for Advanced Medicine, M.D. Anderson Cancer Center, Memorial Sloan Kettering, University of Michigan, and Stanford University.