CxBladder Monitor Testing to Inform the Need for Surveillance Cystoscopy

By GU Oncology Now Editors - December 3, 2021

At the 22nd Annual Meeting of the Society of Urologic Oncology, researchers presented findings from a pilot study of the CxBladder Monitor (CxM) urine test that assessed its value in indicating a need for surveillance procedure.

According to the study’s lead author, Kevin D. Li, from the Department of Urology of the UCSF School of Medicine, “CxM was feasible and safe for patients on surveillance for non-muscle invasive bladder cancer (NMIBC) and decreased frequency of cystoscopy.”

Fifty-two patients with NMIBC due for surveillance cystoscopy were offered CxM prior to scheduling a clinic visit and surveyed about ease, affordability, and acceptability of the test. A CxM score ≥3.5 was used to proceed with cystoscopy while a score below that led to deferment (negative predictive value = 97%). Outcomes of interests included whether in-office cystoscopy was deferred or performed based on CxM and detection of urothelial cancer at immediate or next surveillance cystoscopy.

The trial found that patients with CxM ≥3.5 (17/52; 33%) were more likely to present with high-grade disease at diagnosis versus those with CxM <3.5 (78% vs. 64%). Otherwise, CxM ≥3.5 did not relate to age, gender, race, history of upper tract urothelial cancer, T stage, or prior recurrences. Among the 17 patients with CxM ≥3.5, 14 underwent immediate cystoscopy, of which seven had findings necessitating biopsy.

Thirty-five patients with CxM scores <3.5 deferred cystoscopy to next visit (63% at 3 months, 34% at 6 months, or 3% at 9 months). Of those, 32 subsequently underwent surveillance cystoscopy (median = 4.0 months after) with no notable detections.

Given the need to minimize risks of transmission, the report suggested that “CxM may be used to further risk stratify patients to deintensify surveillance for NMIBC during the COVID-19 pandemic and beyond.”