The case for urine-based biomarkers in bladder cancer


Bladder cancer is among the most expensive cancers to treat. Reasons for this include a high recurrence rate and the need for ongoing invasive surveillance. Patients with a known history of bladder cancer must undergo extensive surveillance through procedures such as cystoscopy, which adds to the cost element and is an invasive method. The arrival of biomarkers could be the beginning of a new era of managing recurrent bladder cancers.

At the recent conference organized by the European Association of Urology in London, a number of studies focused on the significance of urine-based biomarkers in the management of bladder cancer and its recurrence in patients with previous history of the cancer. The results of these studies are promising, and hastens the race to establish a more non-invasive method to monitor bladder cancer. The spectrum of these studies ranged from the validation of biomarkers for the detection of bladder cancer and its recurrence, to different techniques of analyzing these biomarkers, which can either be DNA, ribonucleic acid (RNA), or protein based.

One factor that is propelling the growth of research in this area is the need to replace the current invasive surveillance techniques with a cost-effective alternative. Another factor, which is likely the primary enabler of this approach, is the evolution of advanced technological platforms. One example of this is the Xpert Bladder Cancer Monitor from Cepheid, which was launched commercially in October 2016 in Germany and cleared for commercial availability in all countries accepting the CE mark. The system utilizes a urine specimen and is designed to provide information on cancer recurrence for bladder cancer patients.

Systems that are capable of providing similar qualitative outputs are set to contribute to the cost savings for healthcare systems in this space. With the increasing demand to move away from invasive techniques, such as cystoscopy for monitoring bladder cancer, urine-based biomarkers could act as the optimal replacement for these procedures; this would be a win-win situation for hospitals, patients, and medical device companies alike.