scholarly journals Genetics and biomarker in bladder cancer for optimized clinical decision-making and improved outcomes

2017 ◽  
Vol 6 (6) ◽  
pp. 1014-1017
Author(s):  
Michael Rink
Keyword(s):  
Decision Making ◽  
Bladder Cancer ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Improved Outcomes

scholarly journals Molecular Markers for Bladder Cancer Screening, Early Diagnosis, and Surveillance: The WHO/ICUD Consensus

2014 ◽  
Vol 94 (1) ◽  
pp. 1-24 ◽  
Author(s):  
Bernd J. Schmitz-Dräger ◽  
Michael Droller ◽  
Vinata B. Lokeshwar ◽  
Yair Lotan ◽  
M''Liss A. Hudson ◽  
...  
Keyword(s):  
Decision Making ◽  
Bladder Cancer ◽  
Molecular Markers ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Urine Cytology ◽  
Added Value ◽  
Current Status ◽  
Low Grade ◽  
Screening And Surveillance

Due to the lack of disease-specific symptoms, diagnosis and follow-up of bladder cancer has remained a challenge to the urologic community. Cystoscopy, commonly accepted as a gold standard for the detection of bladder cancer, is invasive and relatively expensive, while urine cytology is of limited value specifically in low-grade disease. Over the last decades, numerous molecular assays for the diagnosis of urothelial cancer have been developed and investigated with regard to their clinical use. However, although all of these assays have been shown to have superior sensitivity as compared to urine cytology, none of them has been included in clinical guidelines. The key reason for this situation is that none of the assays has been included into clinical decision-making so far. We reviewed the current status and performance of modern molecular urine tests following systematic analysis of the value and limitations of commercially available assays. Despite considerable advances in recent years, the authors feel that at this stage the added value of molecular markers for the diagnosis of urothelial tumors has not yet been identified. Current data suggest that some of these markers may have the potential to play a role in screening and surveillance of bladder cancer. Well-designed protocols and prospective, controlled trials will be needed to provide the basis to determine whether integration of molecular markers into clinical decision-making will be of value in the future.

Prediction of progression to MIBC for pT1 bladder cancer: Development of a clinical decision-making tool

2017 ◽  
Vol 16 (11) ◽  
pp. e2937
Author(s):  
M. Abufaraj ◽  
D. D’Andrea ◽  
R. Ristl ◽  
B. Foerster ◽  
C. Seitz ◽  
...  
Keyword(s):  
Decision Making ◽  
Bladder Cancer ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Cancer Development ◽  
Decision Making Tool

Considerations on implementing diagnostic markers into clinical decision making in bladder cancer

2010 ◽  
Vol 28 (4) ◽  
pp. 441-448 ◽  
Author(s):  
Yair Lotan ◽  
Shahrokh F. Shariat ◽  
Bernd J. Schmitz-Dräger ◽  
Marta Sanchez-Carbayo ◽  
Feliksas Jankevicius ◽  
...  
Keyword(s):  
Decision Making ◽  
Bladder Cancer ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Diagnostic Markers

scholarly journals Sensitivity and Specificity in Urine Bladder Cancer Markers – Is it that Simple?

2021 ◽  
pp. 1-4
Author(s):  
Florian Roghmann ◽  
Peter J. Goebell ◽  
Lars Dyrskjøt ◽  
Bas W.G. van Rhijn ◽  
Heiko U. Käfferlein ◽  
...  
Keyword(s):  
Decision Making ◽  
Bladder Cancer ◽  
Clinical Decision Making ◽  
Prospective Trial ◽  
Clinical Decision ◽  
The Past ◽  
Large Numbers ◽  
Urine Bladder ◽  
Level 1 ◽  
Current Guidelines

Marker research and, in particular urine bladder cancer marker research throughout the past three decades, devours enormous scientific resources in terms of manpower (not to mention time spent on reviewing and editorial efforts) and financial resources finally generating large numbers of manuscripts without affecting clinical decision making. This is mirrored by the fact that current guidelines do not recommend marker use due to missing level 1 evidence. Although we recognize the problems and obstacles, the authors of this commentary feel that the time has come to abandon the current procedures and move on to prospective trial designs implementing marker results into clinical decision making. Our thoughts and concerns are summarized in this comment.

Patient-centric care in bladder cancer: Virtual simulation to benefit clinical decision-making of oncologists.

2021 ◽  
Vol 39 (6_suppl) ◽  
pp. 492-492
Author(s):  
Kinjal Parikh ◽  
Donna L. Topping ◽  
Saee Dhoble ◽  
Jacob Cohen ◽  
Haleh Kadkhoda ◽  
...  
Keyword(s):  
Decision Making ◽  
Bladder Cancer ◽  
Clinical Decision Making ◽  
Real Life ◽  
Clinical Decision ◽  
Decision Point ◽  
Appropriate Therapy ◽  
Specific Factors ◽  
Disease Specific

492 Background: Immunotherapy (IO) utility in bladder cancer (UC) has expanded into multiple stages of disease. Employing IO optimally requires mastery of clinical trial data, patient eligibility criteria, and interpretation of biomarkers and determination of treatment sequencing. Given the nuanced therapeutic decision-making, education was developed in partnership between Medscape Oncology and Society for Immunotherapy of Cancer (SITC) to assist oncologists in improving their performance surrounding the management of patients with advanced UC. Methods: A virtual patient simulation (VPS) continuing medical education (CME)-certified activity depicting 2 advanced UC cases was made available to oncologist members of Medscape. The cases depicted 1) a patient with newly diagnosed metastatic UC with comorbidities and PDL1+ disease and 2) a patient with advanced UC progressing on platinum therapy with no actionable mutations. The VPS platform captures real-life decision making process of oncologists in an EHR-like format supported by an extensive database of diagnostic and treatment possibilities. Learners were able to interact with patients via video, order lab tests, assess patients, make diagnoses, and order treatments matching the scope and depth of actual practice. Tailored clinical guidance (CG) employing up-to-date evidence-based and faculty recommendations was provided after each decision point. Decisions were collected pre- and post-CG and analyzed using McNemar’s test to determine p-values. Data were collected from 4/28/20 to 7/13/20. Results: Analyses from oncologists (n = 51-66) found significant improvement in performance measured pre- to-post CG: Case 1: Ordering appropriate testing to determine patient eligibility for therapy (39% pre; 65% post; p < .001) Prescribing appropriate therapy based on patient- and disease-specific factors (38% pre; 77% post; p < .001) Providing appropriate counseling and follow-up for a patient receiving treatment (65% pre; 80% post; p < .01) Case 2: Ordering appropriate testing to determine patient eligibility for therapy (39% pre; 57% post; p < .01) Prescribing appropriate therapy based on patient- and disease-specific factors (25% pre; 41% post; p < .01) Providing appropriate counseling and follow-up for a patient receiving treatment (71% pre; 82% post; p < .05). Conclusions: This activity demonstrates the value of providing oncologists a simulation platform to practice and master clinical decision-making of the limitless possible diagnostic and therapeutic options in the management of advanced UC. Insights from rationales for each clinical decision point uncover continued gaps for oncologists on guideline recommendations, efficacy outcomes, or molecular implications. They also highlight barriers including limited experience or confidence with IO.

scholarly journals A húgyhólyag urothelialis daganatainak molekuláris alcsoportbeosztása és annak klinikai vonatkozásai

2019 ◽  
Vol 160 (42) ◽  
pp. 1647-1654 ◽  
Author(s):  
Tibor Szarvas ◽  
Csilla Oláh ◽  
Péter Riesz ◽  
Lajos Géczi ◽  
Péter Nyirády
Keyword(s):  
Decision Making ◽  
Bladder Cancer ◽  
Clinical Decision Making ◽  
Checkpoint Inhibitors ◽  
Clinical Decision ◽  
Molecular Techniques ◽  
Invasive Bladder Cancer ◽  
Muscle Invasive Bladder Cancer ◽  
Gene And Protein Expression ◽  
Muscle Invasive

Abstract: Current advances in molecular techniques and bioinformatics allowed the analysis of complex molecular patterns in various cancers including muscle-invasive bladder cancer. As a consequence, in the last few years numerous gene- and protein expression-based molecular classifications have been recommended. Recently a comprehensive consensus classification for muscle-invasive urothelial bladder cancer has been published, distinguishing 6 subgroups with a potential impact on clinical decision-making. At the same time, the therapeutic landscape of muscle-invasive bladder cancer becomes increasingly differentiated as novel checkpoint inhibitors have been available for cisplatin-ineligible and/or resistant patients. Furthermore, promising results have been obtained with FGFR targeting agents. Therefore, molecular subtyping will probably have a crucial role in individualized therapeutic decision-making in bladder cancer. In the present work, we summarize the evolution, recent advances and potential therapeutic relevance of molecular subclassifications in bladder cancer. Orv Hetil. 2019; 160(42): 1647–1654.

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