Cytokine Panel for Response to Intravesical Therapy (CyPRIT): Nomogram of Changes in Urinary Cytokine Levels Predicts Patient Response to Bacillus Calmette-Guérin.

UNLABELLED: The response of non-muscle-invasive bladder cancer (NMIBC) to intravesical immunotherapy with bacillus Calmette-Guérin (BCG) depends on adequate stimulation of an immune response. Although BCG has been used for decades, we lack tools to accurately predict response in individual patients. To address this deficiency, we initiated a clinical trial in patients with intermediate- and high-risk NMIBC. BCG was administered according to the Southwest Oncology Group protocol. Urine samples were collected for cytokine assay at baseline, immediately before and after BCG instillation at 6 wk, and immediately before and after the third BCG instillation of the first maintenance course. Levels of 12 cytokines were measured, and changes from baseline were calculated after treatment. A total of 130 patients were enrolled. Increases in single cytokines correlated with recurrence, but the best predictor of recurrence was changes in a combination of cytokines. A nomogram (CyPRIT) constructed using urinary levels of nine inducible cytokines (IL-2, IL-6, IL-8, IL-18, IL-1ra, TRAIL, IFN-γ, IL-12[p70], and TNF-α) predicted the likelihood of recurrence with 85.5% accuracy (95% confidence interval 77.9­93.1%)." This cytokine panel and nomogram have potential for identifying patients at risk of tumor recurrence during BCG treatment to guide modification of the dose and duration of BCG immunotherapy. TRIAL REGISTRATION: Clinicaltrials.gov NCT01007058.

Identification and preliminary clinical evaluation of a 50.8-kDa serum marker for prostate cancer.

OBJECTIVES: To identify a 50.8-kDa biomarker to perform a preliminary clinical evaluation of its utility as an aid in the early detection of prostate cancer. METHODS: The 50.8-kDa protein, previously called NMP48, was partially purified from the serum of an individual with prostate cancer and identified by peptide mass fingerprinting of tryptic peptides from an in-gel digest. Serum samples were obtained from men with biopsy-confirmed prostate cancer, high-grade prostatic intraepithelial neoplasia, and benign histologic features, from men with clinically defined benign prostatic hyperplasia, and from controls without prostatic disease. These samples were analyzed for the presence of the biomarker by surface-enhanced laser desorption/ionization time-of-flight mass spectrometry. RESULTS: The 50.8-kDa protein was identified by peptide mass fingerprinting as being related to vitamin D-binding protein. It was found in 96% of the sera from individuals with prostate cancer (n = 52) including 11 of 12 specimens that exhibited prostate-specific antigen values of less than 4 ng/mL. The 50.8-kDa protein was found in 10 of 19 samples from men with prostatic intraepithelial neoplasia; however, it was not detected in the sera of 5 (75%) of 20 individuals with benign prostatic histologic features, 7 (70%) of 10 with clinical benign prostatic hyperplasia, 8 (80%) of 10 patients who had previously undergone radical prostatectomy, or 48 (96%) of 50 specimens from healthy controls. CONCLUSIONS: Although the study cohort was relatively small, the data suggest that an assay for the 50.8-kDa protein may be useful for the early detection of prostate cancer. Additional elucidation of its structure may yield insight into the development of this disease.