Joshua Meeks, MD, PhD, assistant professor of urology, biochemistry, and molecular genetics, Northwestern University Feinberg School of Medicine, section chief of robotic surgery, Jesse Brown VA Medical Center, discusses the role of smoking status in the diagnosis of bladder cancer.

Bladder cancer has historically been linked to smoking, Meeks says. When The Cancer Genome Atlas (TCGA) first detailed the gene expression profiling, whole-exome sequencing, methylomics, and regulons of more than 400 patients with bladder cancer in 2014, Meeks says that he was shocked that the mutations identified in smokers were the same mutations identified in nonsmokers. Additionally, the gene expression profiles did not show any differences.

Although the overall number of mutations was not different in the 2 groups, the signatures were completely different in smokers and nonsmokers, Meeks explains. The utility of this information is not known. Meeks says that the biggest question is where the mutations are coming from in non-smokers. The next step is to find out where those cancers come from, and figure out if there are ways to prevent or target it.  

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Joshua Meeks, MD, PhD, assistant professor of urology, biochemistry, and molecular genetics, Northwestern University Feinberg School of Medicine, section chief of robotic surgery, Jesse Brown VA Medical Center, discusses the role of smoking status in the diagnosis of bladder cancer.
 

Dr. Meeks Discusses Smoking Status in Bladder Cancer

Joshua Meeks, MD, PhD, assistant professor of urology, biochemistry, and molecular genetics, Northwestern University Feinberg School of Medicine, section chief of robotic surgery, Jesse Brown VA Medical Center, discusses the genomics of bladder cancer.

The framework of bladder cancer can be divided into that of muscle invasive bladder (MIBC) and non-muscle invasive bladder cancer (NMIBC), explains Meeks. In the Cancer Genome Atlas (TCGA), data was compiled on gene expression profiling, whole exome sequencing, methylomics, and regulons of over 400 patients with MIBC.

Now, research is directed toward NMIBC, says Meeks. It is now known that there are less mutations that are present in NMBIC than in MIBC. Additionally, different pathways seem to be activated in these tumors that are absent in MIBC. This points to the heterogeneity of these cancers. Dealing with this heterogeneity in terms of targets and approaches is going to be the next direction in how physicians are able to orient and apply this information moving forward.

Joshua Meeks, MD, PhD

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Dr. Meeks Discusses Smoking Status in Bladder Cancer

Dr. Meeks on the Genomics of Bladder Cancer