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Urinary biomarkers in bladder cancer

where do we stand?

Bhat, Abhisheka; Ritch, Chad R.a,b

doi: 10.1097/MOU.0000000000000605
BLADDER CANCER: Edited by Siamak Daneshmand

Purpose of review To provide a current comprehensive review of the available urinary biomarkers for the detection and surveillance of bladder cancer.

Recent findings The limitations of urine cytology and invasive nature of cystoscopic evaluation have led to a growing search for an ideal, cost-effective biomarker with acceptable sensitivity and specificity. Current FDA approved biomarkers such as UroVysion fluorescent in situ hybridization, Immunocyt, and nuclear matrix protein 22 do not have the specificity, and thus positive predictive value to warrant their cost as a routine adjunct or replacement for cystoscopy. Several promising commercially available assays such as Cxbladder, Assure MDx, and Xpert BC may perform better than cytology in select populations. Novel genomic, epigenetic, inflammatory, and metabolomic-based assays are being analyzed as potential urinary biomarkers.

Summary Urinary biomarkers with high sensitivity and specificity are an unmet need in bladder cancer. Several new assays may meet these criteria and future research may justify use in clinical practice.

aDepartment of Urology, University of Miami, Miller School of Medicine

bDepartment of Urologic Oncology, Sylvester Comprehensive Cancer Center, Miami, Florida, USA

Correspondence to Chad R. Ritch, Department of Urology, Miller School of Medicine, University of Miami, 1120 NW 14th St, Miami, FL 33138, USA. Tel: +1 305 243 6596; e-mail:

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