CxBladder Surveillance of Intermediate and High-Risk Bladder Cancer Patients

This is a multi-site study recruiting subjects from Veterans Affairs and other medical centers. Subjects will be prospectively recruited to an observational study to validate the performance characteristics and clinical utility of CxBladder Monitor test (CxbM). The study will recruit intermediate and high-risk surveillance subjects, defined as per American Urological Association (AUA) / Society of Urologic Oncology (SUO) guidelines 2016 amendment 2020, previously diagnosed with urothelial carcinoma (UC).Eligible subjects will include those under surveillance for recurrence of UC. A strength of the proposed design is that subjects with primary or recurrence of UC can be recruited. This means, for some subjects, that there may be a range of surveillance visits prior to enrolment. A voided urine sample will be collected from each enrolled subject at each of 4 successive surveillance visits. Records review will occur 12, 24 and 48 months after the final urine sample is collected. The collected urine will be used for CxBladder testing and central urine cytology. The study will collect primary tumour tissue from the first (primary) tumour and also from the most recent recurrence, if any, in order to genotype each tumour using RNA or DNA markers indicative of an elevated risk of UC. CxBladder results will not be reported to patients or physicians. The objective of this study is to evaluate a new proposed pathway over a period of up to four visits where CxbM is alternated with cystoscopy at consecutive visits for intermediate and high-risk surveillance subjects. The new proposed pathway will be compared directly to standard of care. Analysis of data will include determining the proportion of subjects that are positive by surveillance cystoscopy (standard of care) following a negative diagnosis at the previous visit. Using the same dataset, analysis of data will include determining the proportion of subjects that are positive by surveillance cystoscopy (standard of care) following a negative CxBladder result at the previous visit. Analysis will include assessment of the theoretical possible reduction in cystoscopy procedure use associated with the new pathway. Sites are required to be competent in recruiting and completing required test request forms, Case Report Forms (CRF) and sample collection in a professional manner in accordance with good clinical practice (GCP).