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TP53-Mutated Bladder Cancer: Identifying Patients Who May Benefit From Immunotherapy

By: Kelly M. Hennessey, PhD
Posted: Monday, April 19, 2021

Immune checkpoint inhibitors have shown promise in treating bladder cancer, yet only a tiny percentage of patients with bladder cancer have obtained clinical benefit from these agents. Jian Zhang, MD, of Zhujiang Hospital, Southern Medical University, Guang Zhou, China, and colleagues found that patients with bladder cancer with the mutated TP53 gene are more likely to benefit from immune checkpoint inhibitors than those with wild-type TP53. Their findings were published in Cancer Control.

Data from 412 patients in The Cancer Genome Atlas-Bladder Cancer cohort, 210 patients in an immunotherapy cohort, and 18 bladder cancer cell lines from Genomics of Drug Sensitivity in Cancer were the focus of the study. The goal was to investigate the underlying mechanisms and relationship between TP53-mutated disease and immune checkpoint inhibitors. Patients in the immunotherapy cohort were grouped based on their TP53 status to compare patient clinical and genomic characteristics.

There was a significant association with prolonged overall survival for patients with bladder cancer in the immunotherapy cohort who had mutated TP53 compared with patients with wild-type TP53 bladder cancer. The prognosis for patients with mutated TP53 treated with non–immune checkpoint inhibitors was not statistically different from that of patients with wild-type TP53. Patients experienced similar overall survival, progression-free survival, and disease-free survival, suggesting the efficacy of non–immune checkpoint inhibitors may not be related to TP53 status. Researchers also identified that primary versus metastatic cancer type and tumor mutational burden score also seems to be prognostic factors. 

“Our research provides some clues for identifying patients who would potentially benefit from immune checkpoint inhibitors at the DNA level,” summarized the researchers. “This indicator can be coordinated with other indicators to promote the development of precision medicine.”

Disclosure: The study authors reported no conflicts of interest.

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