Exploring heterogeneity in bladder cancer
Research type
Research Study
Full title
Exploring heterogeneity in bladder cancer
IRAS ID
225004
Contact name
Jon Griffin
Contact email
Sponsor organisation
Sheffield Teaching Hospitals NHS Foundation Trust
Duration of Study in the UK
6 years, 0 months, 1 days
Research summary
Patients with non-muscle invasive bladder cancer (NMIBC) have a 10-20% risk of progression to muscle invasive bladder cancer (MIBC). This is associated with an increased risk of cancer spread and death. Patients with MIBC frequently require the surgical removal of their bladder (cystectomy) and chemotherapy. By contrast non-progressive NMIBC can be managed with less invasive techniques and treatments with fewer side effects.
Examination of tumour tissue under a microscope by a histopathologist provides information about NMIBC that stratifies patients into risk groups and informs their follow up and treatment options. However, the risk of tumour recurrence and progression varies widely within these risk groups. Recent studies have found genetic markers that might better predict which patients will go on to have muscle invasive bladder cancer.
Intra-tumour heterogeneity (ITH) describes how a tumour has evolved over time and the finding common to many tumour types that different genetic changes are found in different locations within the same tumour. ITH is also found in how a patient’s immune system responds to a tumour. ITH can cause problems with the reliability of using genetic markers to predict the behavior of a tumour as the most aggressive area of a tumour might not be sampled or adequately represented. Moreover, the presence and magnitude of ITH can be used as a prognostic indicator in some tumour types. ITH has not yet been investigated in NMIBC.
The aims of this project are to investigate the clinical, radiological, microscopic and genetic (DNA and RNA) characteristics of bladder cancer with a focus on intra-tumour heterogeneity and heterogeneity over time.
REC name
Yorkshire & The Humber - Sheffield Research Ethics Committee
REC reference
18/YH/0011
Date of REC Opinion
29 Jan 2018
REC opinion
Favourable Opinion