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Ludwig Stanford researchers devise urine test for bladder cancer

Jan 29, 2019

January 29, 2019, New York — Researchers led by Maximilian Diehn and Ash Alizadeh of the Ludwig Center at Stanford have devised a highly sensitive and noninvasive test for diagnosing and monitoring bladder cancer, the sixth most common cancer in the US.

The most accurate current method for diagnosing bladder cancer is via cystoscopy, an invasive technique to visualize the bladder and take tissue samples. Another noninvasive method that looks for cancer cells in urine has low sensitivity.

Diehn and Alizadeh, who are associate professors at the Stanford School of Medicine, have shown in several studies that they can detect circulating DNA shed by tumors into the blood using a method they’ve developed called CAPP-Seq. For this study, they and their colleagues adapted CAPP-seq to identify bladder cancer DNA in urine, analyzing samples from 67 healthy adults and 118 patients with early stage bladder cancer who gave samples either prior to treatment or during surveillance.

They showed that CAPP-seq could detect bladder cancer in the early stages of development, when it can be treated more easily. It correctly did so in 83% of patients with early stage bladder cancer, compared with a 14% rate for the clinically available urine cytology test.

“We were able to detect bladder cancer recurrence an average of 2.7 months earlier than could be done with cystoscopy,” said Alizadeh. Early detection typically yields far better patient outcomes. CAPP-seq also detected almost all recurrent cases, making it nearly twice as sensitive as cystoscopy and cytology.

The test will have to be vetted in larger clinical studies before it can be put to use in medical practice.

The researchers believe that the method of looking for cancer DNA in body fluids other than blood could be more widely applied. “It may eventually be useful for testing saliva for oral cancer, cerebrospinal fluid for neurological cancers or sputum for lung cancer,” said Diehn.

These findings were published online Dec. 21 in Cancer Discovery.

The Stanford Medicine article from which this summary is derived can be found here.