Genetic Determinants of Response to Neoadjuvant Cisplatin-based Chemotherapy in Urothelial Cancer

Study Overview
=================
Brief Summary
-----------------
This is observational clinical trial to study adult urothelial cancer patients treated with cisplatin-based neoadjuvant chemotherapy. Hypothesis: Identification of genetic and molecular cisplatin susceptibility biomarkers will allow identification of urothelial cancer patients most likely to benefit from cisplatin-based neoadjuvant chemotherapy.

Detailed Description
-----------------
In this trial patients will submit germline (blood) and tumor tissue samples as part of two existing sample collection protocols for analysis of genetic and molecular markers governing response to chemotherapy. Pathologic review of tissue samples after neoadjuvant therapy will allow determination of the complete response rate (pT0 rate) and this will be compared between patients with susceptible and resistant genetic/molecular cisplatin susceptibility variants. Primary Endpoint: Analysis of whether a small set of previously-identified germline cisplatin susceptibility polymorphisms associate with achievement of a complete pathologic response to neoadjuvant cisplatin-based chemotherapy in urothelial cancer patients. Secondary Endpoints: To perform companion genetic or molecular analyses of other previously-identified gene, SNP, or microRNA cisplatin susceptibility candidates in these patients, using tumor and/or germline tissue. Exploratory Endpoints: To perform unbiased, hypothesis-generating SNP, gene, or microRNA array studies to identify novel germline or tumor determinants which may predict response to cisplatin-based chemotherapy.

Official Title
-----------------
Identification of Genetic Determinants of Response to Neoadjuvant Cisplatin-based Chemotherapy in Urothelial Cancer

Conditions
-----------------
Urothelial Cancer

Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Patients with clinical T2 through T4 urothelial carcinoma of the bladder or upper tract. Patients must be deemed appropriate by the treating physician to require cisplatin-based neoadjuvant chemotherapy for urothelial cancer. Consideration of regional nodal status as part of the decision for appropriateness for neoadjuvant chemotherapy will be left to the treating physician. Patients must be scheduled to proceed to definitive urothelial cancer surgery, including either cystectomy or nephrectomy/ureterectomy, after chemotherapy. Age >18 years. Exclusion Criteria: Patients receiving cisplatin-based chemotherapy for urothelial cancer in the adjuvant setting or for metastatic disease.

Ages Eligible for Study
-----------------
Minimum Age: 18 Years
Maximum Age: 89 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------
What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Genetic Determinants of pT0 Status | To perform genetic analysis of germline samples from these patients to determine whether a set of cisplatin susceptibility polymorphisms predict complete pathologic response to cisplatin-based chemotherapy. | 3 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Molecular Determinants of pT0 Status | To perform companion genetic or molecular analyses of other previously-identified gene, SNP, or microRNA cisplatin susceptibility candidates in these patients, using tumor or germline tissue. | 3 years | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Urothelial, cancer, cisplatin, neoadjuvant, chemotherapy, germline