By measuring specific molecules in bladder cancer cells, doctors may be able to spot which patients are at risk of developing a more lethal strain of the cancer, and determine which therapies might be best for them, researchers reported Wednesday.
　　Scientists in England took cell samples from 34 patients with bladder cancer and identified two factors that may have contributed to 14 of them developing invasive bladder cancer.

Specifically, the investigators found that a protein called p27--which helps block the spread of bladder cancer--was knocked out of action by another molecule called caspase 3 in many of the more aggressive cancers.

According to the report, about two thirds of the patients with the more quickly spreading form of bladder cancer appeared to have lost production of p27 and had an increased level of caspase 3.

"These data suggest that the measurement of both nuclear p27 levels and activated caspase 3 levels may be useful in monitoring patients with bladder cancer," Dr. Paul B. J. Burton of Imperial College School of Medicine in London and colleagues write in the November 9th issue of The New England Journal of Medicine.

The new study findings help identify specific targets for drug therapy that could potentially slow down the spread of the cancer or kill it altogether, according to Dr. Christopher Widnell of the American Cancer Society, based in Atlanta, Georgia.

"In the future, doctors hope to be able take a biopsy of a patient's cancer cells and be able to identify the optimal treatment for an individual tumor," Widnell told Reuters Health in an interview.

Roughly 57,000 people are diagnosed with bladder cancer in the US and the United Kingdom each year. About half of all bladder cancer patients will develop invasive bladder cancer, the authors note.

(From The New England Journal of Medicine 2000;343:1418-1419.)