Urine Tumor DNA to Stratify the Risk of Recurrence in Patients Treated with Atezolizumab for Bacillus Calmette-Guérin–unresponsive Non–muscle-invasive Bladder Cancer
Bibliographic record
Abstract
As new treatments for bacillus Calmette-Guérin (BCG)-unresponsive non-muscle-invasive bladder cancer (NMIBC) emerge, better methods are needed to guide therapeutic decisions. This study analyzed urine tumor DNA (utDNA) from patients treated with atezolizumab in the SWOG S1605 trial to determine whether utDNA profiling can stratify the risk of treatment failure. Urine samples were analyzed using the UroAmp assay at baseline and 3 mo from 89 and 77 patients, respectively. Only 13% of UroAmp-positive patients at baseline achieved a complete response at 6 mo compared with 71% of UroAmp-negative patients (p < 0.001). The 18-mo event-free survival (EFS) was significantly lower for UroAmp-positive patients at baseline (23%) than for UroAmp-negative patients (51%; hazard ratio [HR] 2.8, p < 0.001). Among patients with no clinical evidence of disease at 3 mo (n = 51), the 18-mo EFS was 38% for UroAmp-positive and 86% for UroAmp-negative (HR 3.5, p = 0.01) patients. These findings suggest that utDNA profiling at baseline and after 3 mo of treatment can help identify patients with BCG-unresponsive NMIBC who are less likely to benefit from systemic immunotherapy.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
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 teacher head, 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".