Upper urinary tract carcinoma is a highly challenging disease to diagnose and follow. In contrast to bladder cancer, upper tract tumors are more difficult to diagnose and treat, due to the anatomical considerations and the special medical equipment that is required for the diagnosis and treatment of these tumors. The disease prognosis is heavily influenced by the stage and grade of the disease, which makes early detection of a new and recurrent lesion a major task for the following physician. Cancer detection in urine samples can be the most convenient method for the patient and physician. Although several urine markers are available, none of them is specific and sensitive enough to be used regularly. As a result, most of the physicians worldwide still use urine cytology as the main non-invasive and low risk method for urothelial cancer detection. Using urine cytology generally yields high specificity, but its sensitivity is usually inadequate. Therefore, all urothelial cancer patients will have lifelong, multiple invasive cystoscopies and ionizing radiation imaging, which imply severe side effects, morbidity and even mortality. Hence, a highly specific and sensitive non-invasive marker would alleviate the need for some of the invasive procedures. Semaphorins are a family of membrane-bound, soluble proteins associated with cancer. Specifically, Semaphorin-3A (Sema-3A) was found to be associated with several malignancies, including breast cancer, prostate cancer and lung cancer. The present invention provides methods and kits for the diagnosis, prognosis and monitoring progression of urothelial cancer in a subject. The methods comprise determining the level of Sema-3A in a biological sample of a subject and comparing those levels to a reference or control sample. The invention further provides methods and kits for determining efficacy of a treatment for cancer. A preliminary study showed that Sema-3A is a novel potential marker to detect and follow up upper tract urothelial carcinoma. In the published study, high levels of Sema-3A correlated with upper-tract urothelial cancer stage and displayed higher sensitivity than cytology. Combined analysis of both positive Sema3A and cytology demonstrated 100% sensitivity (Vadasz et. Al, Urologic Oncology, 2018).
- Simple, reliable, highly sensitive and cost-effective methods for determining the presence of urothelial cancer in a biological sample of a subject
Application and Opportunities
- Diagnostic marker for urothelial cancer