Summary
This multi-institutional molecular profiling study identified a rare neuroendocrine-like transcriptomic subtype present in 1–6.6% of muscle-invasive bladder cancers, characterised by heterogeneous expression of neuroendocrine markers without basal or luminal gene expression. Patients with NE-like tumours demonstrated significantly worse clinical outcomes, including reduced 1-year progression-free survival (65% versus 82% overall) and a 6.4-fold increased risk of all-cause mortality after adjustment for clinical and pathologic factors. The authors developed and validated a single-sample random forest classifier that may enable identification of this high-risk subgroup for potential treatment stratification.
UK applicability
This molecular profiling approach could inform urological cancer pathology and treatment stratification in UK NHS centres if validated prospectively. However, the findings are specific to bladder cancer histopathology and do not directly relate to UK farming systems or agricultural food production.
Key measures
84-gene panel expression profiles; 1-year progression-free survival rates; multivariable hazard ratios for all-cause mortality; immunohistochemistry confirmation of neuroendocrine markers
Outcomes reported
The study identified a neuroendocrine-like (NE-like) transcriptomic subtype within muscle-invasive bladder cancer (MIBC) using gene expression profiling and developed a single-sample classifier to predict this high-risk phenotype. Clinical outcomes measured included progression-free survival at 1 year and all-cause mortality risk stratification.
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