“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.
- 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.
- American Cancer Society. What is bladder cancer? http://www.cancer.org/cancer/bladdercancer/detailedguide/bladder-cancer-key-statistics. Accessed February 25, 2014.
- Höjer J, Troutman WG, Hoppu K, et al. Position paper update: ipecac syrup for gastrointestinal decontamination. Clin Toxicol (Phila). 2013;51(3):134-139.
- Foreman KE, Jesse JN 3rd, Kuo PC, Gupta GN. Emetine dihydrochloride: a novel therapy for bladder cancer. J Urol. 2014;191(2):502-509.
- 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.