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Does the Urinary Mast Cell Mediators Predict the Immune Response to BCG in Patients with Primary High-Grade Non-Muscle Invasive Bladder Cancer?
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  • Muhammed Fatih Simsekoglu,
  • İslim Kaleler,
  • Bulent Onal,
  • Cetin Demirdag,
  • Sinharib Citgez,
  • Ezel Uslu,
  • Ahmet Erozenci,
  • Zubeyr Talat
Muhammed Fatih Simsekoglu
Istanbul University-Cerrahpasa Cerrahpasa Faculty of Medicine
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İslim Kaleler
Istanbul University-Cerrahpasa Cerrahpasa Faculty of Medicine
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Bulent Onal
Istanbul Universitesi-Cerrahpasa
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Cetin Demirdag
Istanbul University-Cerrahpasa Cerrahpasa Faculty of Medicine
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Sinharib Citgez
Istanbul University-Cerrahpasa Cerrahpasa Faculty of Medicine
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Ezel Uslu
Istanbul University-Cerrahpasa Cerrahpasa Faculty of Medicine
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Ahmet Erozenci
Istanbul University-Cerrahpasa Cerrahpasa Faculty of Medicine
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Zubeyr Talat
Istanbul University-Cerrahpasa Cerrahpasa Faculty of Medicine
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Abstract

Background: Mast cells play a critical role in tumor-associated immune pathways. We aimed to determine whether the urinary mast cell mediators predict the immune response in patients with non-muscle invasive bladder cancer (NMIBC) treated with Bacillus Calmette-Guérin (BCG) immunotherapy. Methods: Nineteen patients who have received immunotherapy due to NMIBC and 19 healthy participants were enrolled. Urine samples were collected to assay N-methylhistamine, histamine, and tryptase levels immediately before the first BCG instillation, immediately after the third and sixth instillations, and four weeks after the sixth instillation in patients with NMIBC and at a single visit in healthy participants. Cystoscopic examinations were performed on the patient with NMIBC at three-month intervals for two years. The changes in urinary markers due to BCC response, BCG instillation, and the presence of NMIBC were assessed. Results: The average age was 56.1 ± 10.5 years in patients with NMIBC. Fourteen patients had high-grade Ta tumors, and 5 had high-grade T1 tumors. While 12 patients responded, 6 presented with recurrence and 1 with progression. There was no correlation between the levels of mast cell mediators and BCG response. The N-methylhistamine and histamine levels were increased significantly with the onset of immunotherapy, and N-methylhistamine levels were significantly decreased when immunotherapy was terminated. Pre-BCG estimated marginal means of N-methylhistamine were significantly higher in patients with NMIBC than healthy participants. Conclusions: Our study is the first study to identify the changes in mast cell mediators with the onset of immunotherapy and with the presence of bladder cancer. However, these mediators were not found to predict the patients’ response to immunotherapy.

Peer review status:ACCEPTED

17 Nov 2020Submitted to International Journal of Clinical Practice
18 Nov 2020Submission Checks Completed
18 Nov 2020Assigned to Editor
19 Nov 2020Reviewer(s) Assigned
28 Nov 2020Review(s) Completed, Editorial Evaluation Pending
12 Dec 20201st Revision Received
15 Dec 2020Submission Checks Completed
15 Dec 2020Assigned to Editor
15 Dec 2020Reviewer(s) Assigned
18 Dec 2020Review(s) Completed, Editorial Evaluation Pending
21 Dec 2020Editorial Decision: Accept