PD48-07 PIVOTAL STUDY EVALUATING PERFORMANCE OF BLADDER EPICHECK, AN FDA CLEARED TEST, IN NON-MUSCLE INVASIVE BLADDER CANCER
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Résumé
You have accessJournal of UrologyBladder Cancer: Non-invasive III (PD48)1 May 2024PD48-07 PIVOTAL STUDY EVALUATING PERFORMANCE OF BLADDER EPICHECK, AN FDA CLEARED TEST, IN NON-MUSCLE INVASIVE BLADDER CANCER Brant Inman, H. Barton Grossman, Neil Fleshner, Jonathan Wright, Kelvin Moses, Ryan Berglund, Jason Hafron, Lawrence Karsh, Daniel Saltzstein, and Yair Lotan Brant InmanBrant Inman , H. Barton GrossmanH. Barton Grossman , Neil FleshnerNeil Fleshner , Jonathan WrightJonathan Wright , Kelvin MosesKelvin Moses , Ryan BerglundRyan Berglund , Jason HafronJason Hafron , Lawrence KarshLawrence Karsh , Daniel SaltzsteinDaniel Saltzstein , and Yair LotanYair Lotan View All Author Informationhttps://doi.org/10.1097/01.JU.0001008712.53259.7d.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Bladder cancer is the 5th most common cancer in the US. NMIBC surveillance with cystoscopy and cytology is invasive and operator dependent. Bladder EpiCheck (BE) is an accurate non-invasive & objective novel methylation-based PCR urine test included in the EAU guidelines that could potentially augment NMIBC surveillance. These are the results of the FDA pivotal study for BE's 510K clearance. METHODS: A prospective, blinded, multicenter, 3-visit study in 11 centers in USA and Canada. NCT02700464 Adult bladder cancer patients within 12 months of TURBT and under cystoscopic surveillance, were eligible. Patients planned for cystectomy or chemoradiation were excluded. The gold standard (GS) positive was either positive cystoscopy confirmed by pathology or positive cytology (HGUC and SHGUC). All others were considered GS negative. Voided urine was collected prior to cystoscopy. The first GS positive visit was used for analysis and if all visits were negative, the last negative visit was used for analysis. Wash urine samples were excluded. BE detects methylation patterns of 15 loci in urine cell DNA associated with urothelial carcinoma. BE testing was performed on ABI® 7500 Fast Dx PCR (Thermo Fisher) at two central CLIA-certified laboratories in the US. RESULTS: 674 subjects were enrolled and 449 were included in analysis (Figure 1). Median age was 71 (38-93), 79% were male, 47% had history of ≥1 recurrence and 51% were treated with instillations since last TURBT. Overall sensitivity, specificity, NPV and PPV were 67%, 84%, 85%, 65%, respectively. HG sensitivity and NPV were 77% and 95% (Table 1). Performance was statistically different by grade, but not impacted by any other factor including, sex, smoking history, occupational risk, time from last instillation treatment. In patients with a negative GS, the rate of subsequent recurrence at one of the two first study visits was 53% compared to 10% of subjects with positive and negative BE, respectively. CONCLUSIONS: BE performance could improve timely disease recurrence detection and compliance with NMIBC surveillance. BE's high HG NPV supports the use as a rule-out test for HG disease. With high specificity and PPV, BE's false positive rates are low, potentially minimizing unnecessary downstream procedures and patient anxiety. Download PPT Source of Funding: Nucleix Ltd © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e990 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Brant Inman More articles by this author H. Barton Grossman More articles by this author Neil Fleshner More articles by this author Jonathan Wright More articles by this author Kelvin Moses More articles by this author Ryan Berglund More articles by this author Jason Hafron More articles by this author Lawrence Karsh More articles by this author Daniel Saltzstein More articles by this author Yair Lotan More articles by this author Expand All Advertisement PDF downloadLoading ...
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,002 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,015 | 0,003 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».