A team from the Institut Curie (CNRS UMR144 / Sorbonne University) led by Professor Yves Allory and Drs Isabelle Bernard-Pierrot and François Radvanyi, recently showed that the evolution after treatment with neoadjuvant chemotherapy differs depending on the tumor subtype. molecular in patients with bladder cancer. These new data, published on September 17, 2024, were obtained from the results of the VESPER clinical trial, and open the way to new avenues of fundamental and clinical research on bladder cancers.
The VESPER clinical study, the results of which were published in 2022 and in which researchers from the Institut Curie and French teams coordinated by Professors Pfister and Professor Culine participated, led to changes in the management of cancers of the bladder: in fact, the combination of neoadjuvant drugs tested in the study (methotrexate, vinblastine, doxorubicin and cisplatin at a dense dose) proved to be more effective than the other protocol commonly used until now (gemcitabine and cisplatin) .
“Given the robustness of the results obtained during this study, due to the number of patients and the quality of the samples recovered, we were able to use them for additional analyzes in more fundamental research” explains Professor Yves Allory, pathologist in the diagnostic and theranostic medicine center at the Hospital Complex and researcher attached to the Cellular Biology and Cancer unit (CNRS UMR 144 / Sorbonne University) at the Institut Curie Research Center.
There are different categories of bladder cancer on a molecular level, but which have not been taken into account in the study of the effectiveness of treatments. It is on this point that the team questioned itself during this new study. They were able to show that, despite an overall improvement in the prognoses of bladder cancers, the prognosis of so-called “basal” tumors remains poor.
“Our results here show that there are also particularities to take into account depending on the subtypes of bladder cancer. These must be explored in order to improve prognosis and treatments.”
The team also highlighted the presence of heterogeneity even within certain tumors, detectable in patients thanks to tissue samples from different locations, and this heterogeneity of so-called “mixed” tumors is also bad. prognosis The question of this heterogeneity and in particular its role in resistance to treatment is present in many cancers, opening the way to numerous collaborations with other research teams. The project will also continue around the exploitation of algorithms using artificial intelligence, to always better detect and provide better care.
Reference : CS Groeneveld, J. Pfister, S. Culine, V. Harter, J. Krucker, J. Fontugne, V. Dixon, N. Sirab, I. Bernard-Pierrot, A. de Reyniès, F. Radvanyi, Y. Allory
Basal/squamous and Mixed subtype bladder cancers present poor outcomes after neoadjuvant chemotherapy in the VESPER trial. Annals of oncology (17 septembre 2024) doi : 10.1016/j.annonc.2024.09.008.
