Reflex somatic testing for the detection of <i>FGFR</i> alterations in urinary tract carcinomas: A dual-institutional experience
Bibliographic record
Abstract
OBJECTIVE: To describe the prevalence and clinicopathologic associations of FGFR-altered urinary tract carcinomas in institutions incorporating reflex testing. METHODS: Next-generation sequencing was prospectively performed on urinary tract carcinomas for the detection of FGFR1-4 alterations at 2 tertiary care centers (2021-2025), using the Oncomine Comprehensive Assay (OCA) v3 DNA and OCA Plus RNA. Reflex testing was conducted on metastatic and/or advanced (pT3/4) carcinomas. RESULTS: The cohort included 366 patients (239 lower tract carcinomas, 72 upper tract carcinomas, and 55 metastases). Median age was 72.5 years (range, 36-97). Fifty-nine (16.1%) tumors were FGFR-altered. Forty-nine (13.4%) patients with actionable FGFR alterations (33 FGFR3 mutations, 13 FGFR3 fusions, and 3 FGFR2 mutations) were all 55 years or older (P = .097). The prevalence of actionable FGFR alterations was significantly higher in upper vs lower tract carcinomas (23.8% vs 13.8%, P = .007) and in lung metastases vs other metastatic sites (57.1% vs 10.4%, P = .002). A higher frequency was also seen in metastases vs primary tumors (16.4% vs 12.9%), although this difference did not reach statistical significance (P = .482). Actionable FGFR alterations were observed in urothelial carcinoma not otherwise specified (40/261) and in urothelial carcinoma with squamous differentiation (6/43), micropapillary features (2/11), or nested features (2/7). CONCLUSIONS: The detection rate for FGFR1-4 alterations in a real-world, dual-institution cohort of urinary tract carcinomas was reported.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.001 | 0.002 |
| 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 | 0.001 |
| 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".