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ESMO 2022: Can a Calculated Hypoxia Score Lead to Personalized Treatment in Bladder Cancer?

By: Joshua D. Madera, MS
Posted: Wednesday, September 14, 2022

For patients with muscle-invasive bladder cancer, the use of a hypoxia score may serve as a diagnostic strategy to personalize treatment, according to a poster presented at the European Society for Medical Oncology (ESMO) Congress 2022 (Abstract 1734MO). However, additional investigative efforts using a biomarker-stratified trial are necessary to further support these findings, explained Tim A. Smith, PhD, of the University of Manchester, UK, and colleagues.

Tissue biopsies from 312 patients with muscle-invasive bladder cancer were collected from the Bladder Cancer 2001 (BC2001) cohort prior to treatment. RNA was extracted from these samples to measure the expression of 24-signature genes hypoxia score. Patients were subsequently stratified into low– and high–hypoxia score cohorts. These data were further compared with the previously published data of 151 patients from the Bladder Carbogen Nicotinamide (BCON) trial.

Both univariate and multivariate analyses determined a prognostic relationship between hypoxia score and overall survival in patients from the BC2001 cohort (hazard ratio [HR] = 1.29). However, when these patients were stratified into low– and high–hypoxia score cohorts, no significant relationship was identified. Additionally, in patients from the BC2001 and the BCON plus radiotherapy cohorts, patients with hypoxic tumors treated with hypofractionated radiotherapy had a poorer prognosis than those treated with conventional fractionation radiotherapy (HRs = 1.80 and 14.2, respectively). Furthermore, the use of carbogen plus nicotinamide in combination with hypofractionated radiotherapy resulted in an additive detrimental effect on hypoxia.

Disclosure: The authors reported no conflicts of interest.

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