A newly developed urine test could identify people with bladder cancer more accurately than current diagnostic methods, researchers have found. A team at Stanford University developed the uRARE-seq test, which they say will also allow physicians evaluate the impact of cancer treatment and could even help them understand which patients will respond best to different treatment options. The study was published in the journal Nature Medicine on October 2.
Just under 85,000 people in America are diagnosed with bladder cancer each year, according to the American Cancer Society. Current methods of diagnosis—which can involve an endoscope going into the bladder—may miss around 30 percent of cases, the researchers said. "This could lead to earlier detection of disease, better monitoring for recurrence as well as select better treatments for patients who are already diagnosed," Dr.
Daniel Petrylak, a professor of medicine and urology at Yale University, told Newsweek. The newly developed test will measure RNA messages released by tumor cells into a patient's urine, instead of checking for cancer-related mutations in DNA, which is what most blood and urine liquid biopsies do. RNA is a complex compound that replaces DNA as a carrier of genetic codes in some viruses.
One of the most commonly studied types of RNA is messenger RNA (mRNA), which, along with many other types of RNA, plays important roles in both normal cellular processes and diseases. Some types of RNA have been found to be capable of regulating cancer-associated genes in ways that facilitate tumor development. By checking RNA, it could mean the test will pick up on what genes a cancer cell is using, which gives clinicians an idea of a tumor's behavior.
"RNA analysis is a promising approach for diagnosing bladder cancer since it not only allows detection of bladder cancer but can also indicate how aggressive a tumor is and what the best treatment for a given patient might be," senior author of the study, Dr. Maximilian Diehn, a professor of radiation oncology at Stanford University, told Newsweek. The team reviewed almost 700 urine samples, gathered from both cancer patients and healthy participants, and said the test was able to spot cancer indication correctly in 95 percent of people with the disease, while effectively identifying those who did not have the disease—it was correct 90 percent of the time.
Diehn said this meant they found that RNA analysis "can outperform alternative urine tests including cytology (i.e. looking for intact cancer cells in the urine) or looking for DNA from tumors." He also said that the test can detect "even the earliest and least aggressive types of bladder cancers"—such as non-muscle invasive bladder cancers, which have not yet invaded into the wall of the bladder. "It is possible that the test could enable earlier diagnosis, although more clinical studies will be required to prove that," he said. Not only did the test effectively identify cancerous cells in patients' urine, but it was also able to spot residual disease following surgery and BCG immunotherapy, the researchers said.
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