Kobayashi, Takashi

Abstract Background and Objective: Bladder cancer is the 9th most diagnosed cancer worldwide with high incidences reported in Europe and the United States. Here, we evaluated the real-world performance of a commercially available multiplex immunoassay Oncuria-Detect that detects bladder cancer by simultaneously measuring a panel of 10 biomarker proteins in naturally voided urine samples. Methods: We tested prospectively collected urine samples from a real-world cohort of 1, 002 patients presenting to five USA centers, one European center and one Japanese center with hematuria. Assay results were collated with patient clinical data and a cancer diagnosis was defined by biopsy and pathology. The prevalence of bladder cancer in the cohort was 15.9%. Results: In a training set (n=684), the Oncuria-Detect assay correctly identified bladder cancer in 94/109 cases, representing a sensitivity of 91.8%, specificity of 71.6% (AUC 0.885; 95% CI 0.843 - 0.927) and with improved performance for high-grade bladder cancer and muscle-invasive bladder cancer (sensitivity 93.6% and 92.1%, respectively). In a test cohort of n =339 the AUC for detecting bladder cancer was 0.850 (95% CI 0.779-0.920). Conclusions and Implications: The multiplex Oncuria-Detect assay identified bladder cancer with high sensitivity and NPV, for low-grade and high-grade tumors alike. Oncuria-Detect’s high NPV could effectively rule out 66% of patients from requiring subsequent cystoscopy. Citation Format: Ian Pagano, Zhen Zhang, Sergei Tikhonenkov, Florence Le Calvez-Kelm, Steve Goodison, Toru Sakatani, Kaoru Murakami, Takashi Kobayashi, Howard Kim, Riko Lee, Sunao Tanaka, Charles J. Rosser, Hideki Furuya. Performance of the Oncuria-detect bladder cancer test for evaluating patients presenting with hematuria: results from a real-world clinical setting [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 5919.

Purpose: Bladder cancer (BCa) is one of the most common cancer types worldwide and is characterized by a high rate of recurrence. In previous studies, we and others have described the functional influence of plasminogen activator inhibitor-1 (PAI1) in bladder cancer development. While polymorphisms in PAI1 have been associated with increased risk and worsened prognosis in some cancers, the mutational status of PAI1 in human bladder tumors has not been well defined. Methods: In this study, we evaluated the mutational status of PAI1 in a series of independent cohorts, comprised of a total of 660 subjects. Results: Sequencing analyses identified two clinically relevant 3′ untranslated region (UTR) single nucleotide polymorphisms (SNPs) in PAI1 (rs7242; rs1050813). Somatic SNP rs7242 was present in human BCa cohorts (overall incidence of 72%; 62% in Caucasians and 72% in Asians). In contrast, the overall incidence of germline SNP rs1050813 was 18% (39% in Caucasians and 6% in Asians). Furthermore, Caucasian patients with at least one of the described SNPs had worse recurrence-free survival and overall survival (p = 0.03 and p = 0.03, respectively). In vitro functional studies demonstrated that SNP rs7242 increased the anti-apoptotic effect of PAI1, and SNP rs1050813 was related to a loss of contact inhibition associated with cellular proliferation when compared to wild type. Conclusion: Further investigation of the prevalence and potential downstream influence of these SNPs in bladder cancer is warranted.