PD48-07 PIVOTAL STUDY EVALUATING PERFORMANCE OF BLADDER EPICHECK, AN FDA CLEARED TEST, IN NON-MUSCLE INVASIVE BLADDER CANCER
Bibliographic record
Abstract
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 ...
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.015 | 0.003 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".