Evidence map›Paper›PMID 30712971›Full record

ArticleEuropean urology2019

Impact of Immune and Stromal Infiltration on Outcomes Following Bladder-Sparing Trimodality Therapy for Muscle-Invasive Bladder Cancer.

Jason A Efstathiou, Kent W Mouw, Ewan A Gibb, Yang Liu, Chin-Lee Wu, Michael R Drumm, Jose Batista da Costa, Marguerite du Plessis, Natalie Q Wang, Elai Davicioni and 5 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in European urology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 83 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
83citing papers in PubMed, 2 pooled it
22.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

83 citing papers in PubMed, 2 syntheses or guidelines pooled it, 149 citations in OpenAlex.

  1. Pooled it
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  14. Genomic Tumor Correlates of Clinical Outcomes Following Organ-Sparing Chemoradiation Therapy for Bladder Cancer.Clinical cancer research : an official journal of the American Association for Cancer Research · 2023
    Article
  15. Review
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  17. Bladder cancer.Nature reviews. Disease primers · 2023
    Review
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23 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors at 7 institutions in 3 countries.

Jason A EfstathiouDepartment of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. Electronic address: jefstathiou@partners.org.
Kent W MouwDepartment of Radiation Oncology, Dana-Farber Cancer Institute/Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA.
Ewan A GibbGenomeDx Biosciences Inc, Vancouver, Canada.
Yang LiuGenomeDx Biosciences Inc, Vancouver, Canada.
Chin-Lee WuDepartment of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Michael R DrummDepartment of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Jose Batista da CostaDepartment of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada.
Marguerite du PlessisGenomeDx Biosciences Inc, Vancouver, Canada.
Natalie Q WangGenomeDx Biosciences Inc, Vancouver, Canada.
Elai DavicioniGenomeDx Biosciences Inc, Vancouver, Canada.
Felix Y FengDepartment of Radiation Oncology, University of California at San Francisco, San Francisco, CA, USA.
Roland SeilerDepartment of Urology, University of Bern, Bern, Switzerland.
Peter C BlackDepartment of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada.
William U ShipleyDepartment of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
David T MiyamotoDepartment of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Massachusetts General Hospital Cancer Center, Boston, MA, USA.
Genome British Columbia · CAMassachusetts General Hospital · USHarvard University · USUniversity of British Columbia · CADana-Farber Brigham Cancer Center · USUniversity of Bern · CHUniversity of California, San Francisco · US

Funding

Investigating the effect of ERCC2 mutations on DNA repair capacity and chemo-radiotherapy response in muscle-invasive bladder cancerK08CA219504 · NCI · DANA-FARBER CANCER INST · PI MOUW, KENT W · 2017 to 2021
$885k
PROTON THERAPY RESEARCH AND TREATMENT CENTERC06CA059267 · NCI · MASSACHUSETTS GENERAL HOSPITAL · PI GOITEIN, MICHAEL · 1992 to 1995
–
NCI NIH HHS C06 CA059267NCI NIH HHS K08 CA219504
6 · The paper itself

Abstract

backgroundBladder-sparing trimodality therapy (TMT) is an alternative to radical cystectomy (RC) for muscle-invasive bladder cancer (MIBC), and biomarkers to inform therapy selection are needed.

objectiveTo evaluate the prognostic value of immune and stromal signatures in MIBC treated with TMT. DESIGN, SETTING, AND

participantsWe used a clinical-grade platform to perform transcriptome-wide gene expression profiling of primary tumors from 136 MIBC patients treated with TMT at a single institution. We observed 60 overall survival events at 5yr, and median follow-up time for patients without an event was 5.0yr (interquartile range 3.1, 5.0). Expression data from another cohort of 223 MIBC patients treated with neoadjuvant chemotherapy (NAC) and RC were also analyzed. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Molecular subtype, immune, and stromal signatures were evaluated for associations with disease-specific survival (DSS) and overall survival (OS) in TMT patients, and in patients treated with NAC and RC. RESULTS AND LIMITATIONS: Gene expression profiling of TMT cases identified luminal (N=40), luminal-infiltrated (N=26), basal (N=54), and claudin-low (N=16) subtypes. Signatures of T-cell activation and interferon gamma signaling were associated with improved DSS in the TMT cohort (hazard ratio 0.30 [0.14-0.65], p=0.002 for T cells), but not in the NAC and RC cohort. Conversely, a stromal signature was associated with worse DSS in the NAC and RC cohort (p=0.006), but not in the TMT cohort. This study is limited by its retrospective nature.

conclusionsHigher immune infiltration in MIBC is associated with improved DSS after TMT, whereas higher stromal infiltration is associated with shorter DSS after NAC and RC. Additional studies should be conducted to determine whether gene expression profiling can predict treatment response. PATIENT SUMMARY: We used gene expression profiling to study the association between tumor microenvironment and outcomes following bladder preservation therapy for invasive bladder cancer. We found that outcomes varied with immune and stromal signatures within the tumor. We conclude that gene expression profiling has potential to guide treatment decisions in bladder cancer.

Indexed as

Chemoradiotherapy, AdjuvantCystectomyAgedBiomarkersChemotherapy, AdjuvantFemaleHumansInterferon-gammaLymphocyte ActivationLymphocytes, Tumor-InfiltratingMaleMiddle AgedNeoadjuvant TherapyNeoplasm InvasivenessOrgan Sparing TreatmentsPrognosisBiomarkersInterferon-gammaBiomarkerBladder cancerBladder preservationBladder-sparingChemoradiationGene expression profilingImmuneMuscle-invasive bladder cancerRadiationStromalTrimodality therapy

Identifiers

PMID30712971
PMCPMC6571058
OpenAlexW2913857335

What OpenQuestion holds

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Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.