“This is a new concept” explained Dr. Gupta. “Exosomes are a snapshot of what is happening on the inside of a cancer cell. By better characterizing them, they could shed a lot of insight on the nature of a patient’s bladder cancer—that is, are they expressing HER2 or could the patient benefit from a particular chemotherapeutic regimen?”

Dr. Gupta explained that this could lead to personalized medicine for all patients with bladder cancer. Getting a snapshot of the tumor via liquid biopsy using shed cancer exosomes in the urine could be extremely beneficial in the management of the disease. “Patients could be risk-stratified as invasive versus noninvasive or patients could be stratified as potential responders or nonresponders to particular therapies without invasive diagnostic tests,” he said.

Continue Reading


  1. Schneider SA, Sukov WR, Frank I, et al. Outcome of patients with micropapillary urothelial carcinoma following radical cystectomy: ERBB2 (HER2) amplification identifies patients with poor outcome. Mod Pathol. 2013 Nov 1. [Epub ahead of print] doi: 10.1038/modpathol.2013.201.
  2. American Cancer Society. What is bladder cancer? http://www.cancer.org/cancer/bladdercancer/detailedguide/bladder-cancer-key-statistics. Accessed February 25, 2014.
  3. Höjer J, Troutman WG, Hoppu K, et al. Position paper update: ipecac syrup for gastrointestinal decontamination. Clin Toxicol (Phila). 2013;51(3):134-139.
  4. Foreman KE, Jesse JN 3rd, Kuo PC, Gupta GN. Emetine dihydrochloride: a novel therapy for bladder cancer. J Urol. 2014;191(2):502-509.
  5. Franzen C, Simms P, Van Huis A, et al. Characterization of uptake and internalization of exosomes by bladder cancer cells. BioMed Res Int. 2014:1-11.