CXCL11 and CXCR3alt levels predict which bladder cancer patients respond to chemotherapy

Bladder cancer is one of the ten most common cancers in Germany and one of the five most common cancers in men.
germany, about 30,000 people are affected by the disease each year.
cancer is particularly high once it invades the muscle layer in the bladder wall.
for patients with non-metastatic muscle-immersive bladder cancer, treatment usually includes surgical removal of the bladder.
according to current professional guidelines, patients must undergo chemotherapy before surgery;
"newly assisted" chemotherapy is designed to shrink the tumor before surgery to reduce the risk of recurrence and/or metastasis.
, however, chemotherapy does not shrink the tumor in more than 50% of patients.
these patients not only fail to benefit from the new complementary chemotherapy, but also lose valuable time, allowing the cancer to continue to grow and metases.
the new study, Schmück-Henneresse and his team found a way to distinguish between those with bladder cancer who benefit from chemotherapy and those with bladder cancer.
found that the state of the immune system in patients with bladder cancer before treatment begins is key.
chemotherapy proved effective only if the cancerous tissue contained a large number of two special immune system components called CXCL11 and CXCR3alt.
Schmück-Henneresse, said: "The process of measuring these two components in the laboratory is relatively simple, requiring only biopsy samples collected to diagnose the cancer.
this technically simple approach will make it possible to predict the likelihood of successful chemotherapy in a particular patient at diagnosis.
if the new assisted chemotherapy is unlikely to succeed, it can be completely abandoned and transferred directly to the surgical removal of bladder cancer.
this personalized approach not only saves patients from the side effects of ineffective chemotherapy, but may also increase their chances of survival.
, however, our results need to be confirmed by further independent studies to achieve a standard of treatment for patients with bladder cancer by measuring CXCL11 and CXCR3alt.
" as part of the study, the team studied tumor samples from 20 patients with muscle-immersive bladder cancer who completed chemotherapy at the University of Yumo in Sweden.
the samples were collected by Dr. Amir Sherif and his team during a diagnostic cytoscopy procedure before the treatment began.
the researchers identified which immune messenger molecules exist in the biopsy tissue and which recipients are being produced by the immune cells in the tumor (actually the "recipients" of these immune messengers).
for each identified ingredient, they tested whether there was a link between the amount of these ingredients present and the success rate of treatment.
confirmed that the messenger molecule CXCL11 and the subject CXCR3alt were associated with treatment success rates.
chemotherapy only works if the immune cell attraction CXCL11 in tumor tissue is particularly high and a specific immune system cell called T cells produces the corresponding CXCR3alt complex.
, they studied their findings using available data from the Cancer Genome Map.
their comparison confirmed that patients with large amounts of CXCL11 in tumor tissue were more likely to survive in a total of 68 patients with bladder cancer who had underwent chemotherapy.
, lead author of the paper and a doctoral student at the Institute of Medical Immunology at the Schalette School of Medicine in Berlin, explains, "The signaling molecule CXCL11 attracts specific T cells into tumor tissue, where they proliferate and fight cancer.
chemotherapy appears to support the body itself in fighting tumors, possibly because the resulting degradation of cancerous tissue makes it easier for T cells to invade it.
" immune system's impact on treatment outcomes is in direct contradiction to the existing scientific consensus that chemotherapy drugs only work because of their ability to inhibit cancer cell division and replication.
with other studies, our study shows the importance of the immune system's active involvement in fighting tumors," said Vollmer.
" as a next step, the researchers plan to study whether cell therapy can be used to activate T-cells in patients with weak immune system responses to bladder cancer.
, they hope to collect T-cells from these patients, put synthetic CXCR3alts in the lab, and reintrodute them into the patients.
will also look at whether the same method could be used to treat other cancers.
, they plan to advance the use of personalized chemotherapy in patients with bladder cancer.
To achieve this, they plan to use a process called predictive effectiveness to test the predictive power of these two immune system components (CXCL11 and CXCR3alt), which will involve an independent group of patients with muscle-immersive bladder cancer in several European hospitals.
if the predictive reliability of the method is proven, the analysis of the patient's immune status could be a routine tool to support decision-making on bladder cancer treatment," said Dr. Schmück-Henneresse, a professor at the university.
" Reference: 1.Tino Vollmer et al. The intratumoral CXCR3 chemokine system is predictive of chemotherapy response in human bladder cancer. Science Translational Medicine, 2021, doi:10.1126/scitranslmed.abb3735. 2.Bladder cancer—when to use chemotherapy