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Existem mais de 500.000 casos de cancro da bexiga em EUA, e mais de 70.000 novos casos são diagnosticados a cada ano. O cancro de bexiga tem a maior taxa de reincidência de todos os cancros. Como resultado, uma grande percentagem dos pacientes têm, ao longo da vida, prodecimentos de acompanhamento frequentes e dispendiosos (cistoscopia e biópsia) para testar a recorrência e progressão tumoral. Este acompanhamento ao longo da vida faz com que o cancro da bexiga seja o cancro mais caro por paciente. A maioria dos pacientes (70%) apresentam tumores superficiais e os seus cancros podem ser tratados eficazmente. Os tumores superficiais (Ta/T1) são primariamente geridos através de aproximações “bladder-sparing” usando cistoscopia, TURB-T (ressecção trans-uretral do tumor de bexiga) e tratamento intravesicular (ie, BCG). Com tumores muscularres  invasivos (T2 e superior), cistectomia é a estratégia de gestão primária.

Decisões de gestão de doentes são significativamente dependentes de um estadiamento clínico preciso e classificação das amostras de biópsia ou amostras TURB-T. Infelizmente, estudos têm demosntrado que o estádio clínico, frequentemente indica estádios mais precoces de tumor da bexiga comparativamente com o estadiamento patológico e classificação feita após cistectomia. Por exemplo, até 40% dos tumores que se presumem ser T1 (musculares não-invasivo) são demonstrados serem tumores musculares invasivos, quando feito estadiamento pós-cistectomia patológico pouco tempo depois.


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Devido às importantes implicações do estadiamento preciso na correcta avaliação da  agressividade de um tumor e nas decisões de gestão do paciente, a Metabolon está a desenvolver um teste baseado em tecido para avaliar a agressividade do tumor da bexiga através de um teste bioquímico de espécimes de tumor. Este teste irá detectar assinaturas metabólicas associadas com tumores conhecidos por serem agressivos (T2) através do estadiamento patológico pós-cistectomia em espécimes TURB-T/biopsia. Esta informação proporcionará os médicos um aumento do nível de confiança na tomada de decisões de gestão dos pacientes (ou seja, optar por uma estratégia de vigilância ativa ou optar por uma estratégia mais agressiva envolvendo cistectomia).

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Diagnosticar a recorrência de cancro de bexiga depende frequentemente de uma invasiva e cara visualização cistoscópica dos tumores de bexiga e do uso de alguns biomarcadores adjuntos (ou seja, citologia, FISH) para ajudar em certos casos. A Metabolon está a desenvolver um teste de urina não-invasivo baseado na detectação de metabolitos associados a tumores de bexiga com elevada especificidade, independentemente da fase e grau do cancro. Este teste irá ser utilizado para orientar as decisões de gestão do paciente durante a vigilância activa, e pode ser utilizado como um teste gating para cistoscopias iniciais ou de seguimento e outros procedimentos invasivos.

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Depois de cancro da bexiga ser diagnosticado e os pacientes tratados por TURB-T ou cistectomia, os médicos verificam se existem sinais de recorrência local e metastático em intervalos regulares. Lesões metastáticas muito pequenas, conhecidas como micro-metástases, são geralmente assintomáticas e podem não ser detectáveis em exames de imagem como tomografia computadorizada ou ressonância magnética até atingirem um tamanho maior. Se estas micro-metástases forem detectados mais cedo, os médicos podem tratar o paciente mais rapidamente. A Metabolon está a desenvolver um teste de detecção da presença de metástases ocultas e assintomáticas com base num painel de metabolitos em sangue ou urina. Este teste destina-se para o tratamento de seguimento, quer juntamente com os testes de imagem padrão, ou como uma porta de entrada para os testes de imagem. Identificar a doença metastática precocemente, proporciona informações clínicas adicionais importantes na escolha da terapia mais adequada para cada paciente.

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