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

Ashish M. Kamat, Joseph Briggman, Diana L. Urbauer, Robert Svatek, Graciela M. Nogueras González, Roosevelt Anderson, H. Barton Grossman, Ferran Prat, Colin P. Dinney

Research output: Contribution to journalArticlepeer-review

73 Scopus citations

Abstract

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-8, IL-6, IL-1ra, IL-10, IL-12[p70], IL-12[p40], TRAIL, and TNF-α) predicted the likelihood of recurrence with 85.5% accuracy (95% confidence interval 77.9-93.1%). 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.

Original languageEnglish (US)
Pages (from-to)197-200
Number of pages4
JournalEuropean Urology
Volume69
Issue number2
DOIs
StatePublished - Feb 1 2016

Keywords

  • Bacillus Calmette-Guérin response
  • Bladder cancer
  • Nomogram
  • Prediction
  • Urinary cytokines

ASJC Scopus subject areas

  • Urology

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