Recurrence monitoring in Egyptian Bladder Cancer patients using effective and predictive urinary molecular biomarkers: A pilot study

Abstract

Background In Egypt, Urinary bladder cancer (UBC) ranks the 3rd most common cancer, being the second among males and the 7th among females. One relevant mechanism to decrease mortality rate of UBC is to detect its local recurrence through using commercially available effective molecular biomarkers. Purpose We evaluate the diagnostic sensitivity and specificity of the Xpert BC Monitor test in Egyptian patients with non muscle invasive BC. Methodology Liquid biopsies in the form of voided urinary samples were analyzed using the Xpert BC Monitor Kit, measuring the levels of five target mRNAs (ABL1, CRH, IGF2, UPK1B, ANXA10) by RT-PCR in 20 Egyptian patients. Results Two patients (10%) were females and 18 (90%) were males with median age of 66 years. About 80% of the urine samples that were tested in this pilot study were successfully analyzed. Six patients (30%) had positive test results, while 10 patients (50%) had negative test results, 6 of them had radiological evidence of disease. Invalid test results were found in 4 patients (20%). Thus, the test showed 60% sensitivity with 100% specificity and giving positive predictive value of 100% with negative predictive value of 60%. Conclusion Using the non-invasive liquid biopsy method represents a promising tool to improve the current standard of care in patients with non muscle invasive bladder cancer. Further prospective randomized trials with larger patient series and longer follow up period are needed to establish the superiority of Xpert BC Monitor test over the current standard of care in Egyptian BC patients.