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A Kinder, Gentler Bladder Cancer Test


While more research is necessary, and approval by the FDA is required before the test can become routinely available, Altieri says the technology for performing the test already is available and could be performed by doctors at low cost.

Ultimately, if proven successful in future research, the test may be best used in combination with other diagnostic tests.

The survivin study is particularly promising because of the invasive and uncomfortable nature of cystoscopy, says Sudhir Srivastava, PhD, MPH, chief of the cancer biomarkers research group at the National Cancer Institute.

The effort to use survivin to detect bladder cancer recurrence is part of a broad scientific effort to develop biomarkers for a variety of diseases, Srivastava tells WebMD. But the problem of false-positives is one that plagues many of these efforts, some of which have been highly touted by commercial companies without appropriate scientific validation, he says.

"For many years, we have been discovering biomarkers and leaving it there, without taking it further along to prove whether they are clinically applicable," he says. "Validation studies are not very glamorous and do not get the same kind of funding and attention that discovery does."

For that reason, the NCI has developed an Early Detection Research Network to shepherd research on biomarkers from discovery to validation. And he says that the NCI is likely to instigate large-scale trials of survivin to validate the results found by Altieri and colleagues.

"Anyone who has a cancer is looking for the light at the end of the tunnel," he says. "Naturally, they hope to be the first one to use it. We owe it to them to have something that has been proven."

The study by Altieri and colleagues appears in the Jan. 17 edition of the Journal of the American Medical Association.


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