Collaborative study from the Bladder Cancer Advocacy Network for the genomic analysis of metastatic urothelial cancer

Nat Commun. 2022 Nov 4;13(1):6658. doi: 10.1038/s41467-022-33980-9.

Abstract

Urothelial Cancer - Genomic Analysis to Improve Patient Outcomes and Research (NCT02643043), UC-GENOME, is a genomic analysis and biospecimen repository study in 218 patients with metastatic urothelial carcinoma. Here we report on the primary outcome of the UC-GENOME-the proportion of subjects who received next generation sequencing (NGS) with treatment options-and present the initial genomic analyses and clinical correlates. 69.3% of subjects had potential treatment options, however only 5.0% received therapy based on NGS. We found an increased frequency of TP53E285K mutations as compared to non-metastatic cohorts and identified features associated with benefit to chemotherapy and immune checkpoint inhibition, including: Ba/Sq and Stroma-rich subtypes, APOBEC mutational signature (SBS13), and inflamed tumor immune phenotype. Finally, we derive a computational model incorporating both genomic and clinical features predictive of immune checkpoint inhibitor response. Future work will utilize the biospecimens alongside these foundational analyses toward a better understanding of urothelial carcinoma biology.

Publication types

  • Clinical Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Carcinoma, Transitional Cell* / genetics
  • Genomics
  • High-Throughput Nucleotide Sequencing
  • Humans
  • Urinary Bladder / pathology
  • Urinary Bladder Neoplasms* / pathology