An easy-to-administer urine test looking for telomerase reverse transcriptase (TERT) mutations helps detect recurring urothelial bladder cancer, especially non-muscle-invasive bladder cancer, early on, according to a new study.
But how urologists would use this test instead of or in addition to the gold standards cystoscopy and cytology when treating bladder cancer patients remains unclear, according to Badrinath Konety, MD, MBA, of the University of Minnesota, Minneapolis, who was not involved with the study.
Researchers studied 348 subjects treated by transurethral bladder resection for urothelial bladder cancer, to determine whether TERT mutation detection in urine would predict bladder cancer recurrence. They compared results to cytology and cystoscopy in 167 controls.
They found that the TERT test’s overall sensitivity was 80.5% and specificity was 89.8%. Inflammation or infection did not greatly impact results, according to the authors.
A positive postsurgery TERT test was associated with residual carcinoma in situ. The test reliably and dynamically predicted non-muscle invasive bladder cancer recurrence. A positive TERT test after initial surgery increased recurrence risk by 5.34-fold, and was associated with recurrence in patients with negative cystoscopy.
Cytology detected the cancer’s return in 34% of patients, according to the study, which was published online in the British Journal of Cancer (July 6, 2017).
“The standard cytology test needs a doctor to look down a microscope to read the results, but the TERT test is read by a machine which is simpler, more accurate, and available to use straightaway. While the TERT test costs slightly more than standard cytology, it is likely to become cheaper over time,” said study author Alain Ruffion, MD, PhD, of the University Hospital of Lyon's Oncology Institute, in Lyon, France, in a Cancer Research UK press release.