Predictive and prognostic biomarkers of Bacillus Calmette‐Guérin therapy failure in bladder cancer patients: A systematic review

Résumé fourni par la source

High-risk non-muscle invasive bladder cancer (NMIBC) is a common urological malignancy with a high propensity for recurrence (30-40% of patients) despite treatment with Bacillus Calmette-Guérin (BCG) instillations. Identifying patients who are likely to respond or not to BCG therapy before treatment initiation may significantly improve patient outcomes and minimise unnecessary treatments. This systematic review critically assessed the existing literature on the potential of non-invasive biomarkers to predict BCG failure in NMIBC patients. A comprehensive bibliographic search on PubMed, Scopus and Medline databases was conducted to identify relevant studies published up to July 7, 2025. After a thorough screening and selection process, 72 studies were included in the final analysis, 58 of which focused on prognostic markers, 6 on predictive markers, and 8 examined both. Moreover, 55 studies focused on tissue, while 28 studied liquid biopsy-derived biomarkers, showcasing their ability to reflect the dynamic characteristics of the tumour and its microenvironment. The most frequently studied biomarkers comprised p53, Ki-67 and pRB. Furthermore, several immunological markers were also explored, highlighting the current challenge of BCG therapy prediction biomarkers. Despite its valuable insights, this systematic review faced limitations within the included studies, such as issues related to reproducibility, feasibility, and small sample sizes. Nonetheless, the findings indicate that a wide array of molecules show potential as prognostic and/or predictive markers for BCG failure, which may improve the clinical management of this complex disease.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.