Grant: Travel Awards - Institute Community Support

In 2017, bladder cancer was the fifth most common cancer in North America, with non-muscle-invasive bladder cancer (NMIBC) making up nearly 80% of all new cases. These patients are treated with Bacillus Calmette-Guerin (BCG) and typically have favourable long-term survival odds. Unfortunately, bladder tumours are highly prone to recurrence and some will progress to a more aggressive and invasive form after treatment. Up to 60% of patients who receive BCG will see their tumour recur within 2 years and up to half of these will progress, though the mechanism of resistance remains unknown. To study this phenomenon, we have collaborated with an international team of clinicians to collect patient tumour samples from before and after BCG therapy. We subsequently used DNA sequencing to compare the genetic changes between the pre- and post- samples to understand how the tumours responded to treatment. The aim of this research is to find specific indicators that differentiate the patients that respond positively to BCG from those who show resistance, thereby enabling clinicians to personalise therapy to individual patients. We have sequenced 20 patients and identified a number of potential indicators that predict successful outcomes on BCG therapy. This work represents the first time a cohort of NMIBC patients have been genetically profiled both pre- and post- BCG. In light of these findings, we have secured samples from a further 95 patients to continue exploring these trends. Our goal is to identify specific, reproducible indicators that can help guide treatment decisions in the clinic.