Evidence map›Paper›PMID 34782206›Full record

ArticleEuropean urology2022

Different Responses to Neoadjuvant Chemotherapy in Urothelial Carcinoma Molecular Subtypes.

Gottfrid Sjödahl, Johan Abrahamsson, Karin Holmsten, Carina Bernardo, Gunilla Chebil, Pontus Eriksson, Iva Johansson, Petter Kollberg, Claes Lindh, Kristina Lövgren and 5 more

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Article in European urology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 87 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
87citing papers in PubMed, 3 pooled it
30.5field-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

87 citing papers in PubMed, 3 syntheses or guidelines pooled it, 171 citations in OpenAlex.

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  16. Advances in the management of localized bladder cancers.Nature reviews. Clinical oncology · 2026
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27 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 4 institutions in 1 country.

Gottfrid SjödahlDepartment of Translational Medicine, Lund University, Malmö, Sweden; Department of Urology, Skåne University Hospital, Malmö, Sweden. Electronic address: gottfrid.sjodahl@med.lu.se.
Johan AbrahamssonDepartment of Translational Medicine, Lund University, Malmö, Sweden; Department of Urology, Skåne University Hospital, Malmö, Sweden.
Karin HolmstenDepartment of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden; Department of Oncology, Capio S:t Göran Hospital, Stockholm, Sweden.
Carina BernardoDivision of Oncology, Department of Clinical Sciences, Lund University, Lund, Sweden.
Gunilla ChebilDivision of Oncology, Department of Clinical Sciences, Lund University, Lund, Sweden.
Pontus ErikssonDivision of Oncology, Department of Clinical Sciences, Lund University, Lund, Sweden.
Iva JohanssonDivision of Oncology, Department of Clinical Sciences, Lund University, Lund, Sweden.
Petter KollbergDepartment of Translational Medicine, Lund University, Malmö, Sweden; Department of Urology, Skåne University Hospital, Malmö, Sweden.
Claes LindhDepartment of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
Kristina LövgrenDivision of Oncology, Department of Clinical Sciences, Lund University, Lund, Sweden.
Nour-Al-Dain MarzoukaDivision of Oncology, Department of Clinical Sciences, Lund University, Lund, Sweden.
Hans OlssonDepartment of Pathology, Department of Clinical and Experimental Medicine, Medical Faculty, Linköping University, Linköping, Sweden.
Mattias HöglundDivision of Oncology, Department of Clinical Sciences, Lund University, Lund, Sweden.
Anders UllénDepartment of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden; Department of Pelvic Cancer, Genitourinary Oncology and Urology unit, Karolinska University Hospital, Stockholm, Sweden.
Fredrik LiedbergDepartment of Translational Medicine, Lund University, Malmö, Sweden; Department of Urology, Skåne University Hospital, Malmö, Sweden.
Lund University · SEKarolinska Institutet · SEKarolinska University Hospital · SELinköping University · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFor muscle-invasive bladder cancer (MIBC), no tissue biomarkers are available for clinical use to predict response to neoadjuvant chemotherapy.

objectiveTo investigate how molecular subtypes impact pathological response and survival in patients receiving preoperative cisplatin-based chemotherapy. DESIGN, SETTING, AND

participantsClassification of a retrospective cohort of 149 patients was performed by tumor transcriptomic profiling and immunostaining. A cohort treated with radical cystectomy alone and public data sets were used for comparison and external validation. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Complete pathological response in the cystectomy specimen (ypT0N0) and survival were compared in predefined molecular subtypes. Differential gene expression and chemotherapy response were explored beyond molecular subtypes. RESULTS AND LIMITATIONS: Patients with genomically unstable (GU) and urothelial-like (Uro) tumors had higher proportions of complete pathological response (16/31 [52%] and 17/54 [31%]), versus five out of 24 (21%) with the basal/squamous (Ba/Sq) subtype following neoadjuvant chemotherapy and radical cystectomy. Molecular subtype was independently associated with improved survival for patients with GU tumors (hazard ratio [HR] 0.29, 95% confidence interval [CI]: 0.11-0.79) and UroC tumors (HR 0.37, 95% CI: 0.14-0.94) compared with Ba/Sq tumors, adjusting for clinical stage. In addition, expression of the gene coding for osteopontin (SPP1) showed a subtype-dependent effect on chemotherapy response.

conclusionsUrothelial cancer of the luminal-like (GU and Uro) subtypes is more responsive to cisplatin-based neoadjuvant chemotherapy. A second-generation of subtype-specific biomarkers, for example, SPP1, may be a way forward to develop a more precision-based treatment approach for neoadjuvant chemotherapy in MIBC. PATIENT SUMMARY: This study shows that tumor classification by gene expression profiling and molecular subtyping can identify patients who are more likely to benefit from chemotherapy before radical cystectomy for muscle-invasive bladder cancer. Together with other markers for response, molecular subtypes could have a role in selective administration of such chemotherapy.

Indexed as

Carcinoma, Transitional CellUrinary Bladder NeoplasmsChemotherapy, AdjuvantCisplatinCystectomyFemaleHumansMaleNeoadjuvant TherapyNeoplasm InvasivenessRetrospective StudiesTreatment OutcomeCisplatinBasal/squamousBladder cancerChemotherapyCisplatinLuminalMolecular subtypesNeoadjuvantOsteopontinResponseSignatureSPP1SurvivalUrothelial carcinoma

Identifiers

PMID34782206
OpenAlexW3214396654

What OpenQuestion holds

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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.