Bladder Cancer Clinical Trial
Official title:
Prospective Collection of Samples for Urothelial Cancer of Bladder
ProCSUCaB (Prospective Collection of Samples for Urothelial Cancer of Bladder) is a monocentric, non-interventional, prospective registry that will recruit newly diagnosed intermediate- and high-risk NMIBC patients in a tertiary center in Flanders.
ProCSUCaB (Prospective Collection of Samples for Urothelial Cancer of Bladder) is a
monocentric, non-interventional, prospective registry that will recruit newly diagnosed
intermediate- and high-risk NMIBC patients in a tertiary center in Flanders.
Clinical data and biosamples (blood, urine, and BC tissue) will be collected from each
patient at the initial diagnosis before the surgery and will be stored at -80 °C at the
BioBank UZ Leuven after proper processing according to the protocol. High-throughput
multi-omics (genomics, epigenomics, transcriptomics, proteomics, lipidomics, metabolomics)
and immunohistopathology analyses will be performed on these samples.
Patients of both sex and aged ≥18 years, with a signal of clinical diagnosis of BC (symptoms
and/or imaging), are eligible to participate in this study. Patients, who give their informed
consent to collect their biological materials prior to surgery, will be included in the study
after the histopathological diagnosis of the TURBT specimen shows an intermediate- or
high-risk NMIBC. Only the data of the patients with a TCC, with the allowance of any variant
histopathological subtype, will be analyzed.
All patients will be treated and followed up with the standard of care based on the
recommendations of the EAU Guidelines according to their risk groups. All follow-ups will be
scheduled for 5 years as most of the recurrences or progressions occur during this period.
To comply with local privacy laws, all demographic and clinical data (for initial diagnosis
and following recurrences and/or progressions) will be prospectively stored in a specific
database, which is implemented into the hospital's electronic patient file system, and
protected by firewalls [24]. All patients will receive a study identification number, and
names (or any other identifying data) will be removed from the collected biosamples;
therefore, all -omics and pathology laboratories will not know the identity and clinical data
of the patients. The correspondence between the study identification numbers and patient
names will be kept by only the urology department in a secured database.
Blood, urine and BC tissue samples will be collected at the initial diagnosis for every
patient. Blood and urine will be collected by the nurses in the inpatient department in the
morning prior to TURBT. After processing by the dedicated personnel, they will be sent to the
BioBank UZ Leuven, which has continuously monitored and alarmed freezers, robotic handling,
and storage system, and has implemented the Standard Pre-analytical Code (SPREC).
Blood collection: In the morning prior to TURBT (between 07:00-11:00 am), blood will be taken
from the patients into five separate tubes (4x 10 mL EDTA tubes for genomics, epigenomics,
transcriptomics, and proteomics; 1x 6 mL EDTA tube for lipidomics and metabolomics).
Collection date and time will be recorded in the 'Urine/Blood Sampling Form' by the nurse.
All blood tubes will be inverted gently 10 times after blood collection. All EDTA tubes will
immediately be put in the refrigerator at +4°C in upright position until centrifugation. All
blood samples will be centrifuged within 4 hours of collection, and centrifuge date and time
will be recorded in the 'Blood Processing and Storage Form'. After processing all blood
samples according to the specific protocol of each analysis, all plasma/pellet/whole blood
samples in cryovials will be sent to the BioBank UZ Leuven to be stored at -80 °C, and the
date and time of the sample acceptance will also be recorded.
Urine collection: A total of 230 mL of mid-stream urine will be collected into five tubes
from the second urine in the morning (between 07:00-11:00 am) before TURBT. The patient
should be well hydrated. Collection date and time will be recorded in the 'Urine/Blood
Sampling Form' by the nurse. The urine samples will immediately be stored at +4 °C in the
refrigerator and processed within 2 hours after collection, and centrifuge date and time will
be recorded in the 'Urine Processing and Storage Form'. After processing all urine samples
according to the specific protocol of each analysis, all samples in cryovials will be sent to
the BioBank UZ Leuven to be stored at -80 °C, and the date and time of the sample acceptance
will also be recorded.
Tissue collection: During TURBT, if the tumor is large enough (>10 mm in diameter), a big
chip that includes the tumor stalk will be cut with the resectoscope. The sample will be put
in a cryovial, and sent to the BioBank immediately thereafter. The date and time of
collection and acceptance will be recorded in the 'Tissue Sampling and Storage Form'.
Cryosection will be performed from frozen samples by a uropathologist before -omics analyses
to check for presence and area of intermediate- and high-risk NMIBC. After the
uropathologist's report, frozen samples will be dissected to take parts enriched in tumor
cells. The histopathological diagnosis of the patients will be made according to the
hematoxylin-eosin (HE) staining of the slides from the formalin-fixed paraffin-embedded
(FFPE) blocks, which will determine the ultimate inclusion of the intermediate- and high-risk
NMIBC patients.
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