TERT Promoter Mutation as a Potential Predictive Biomarker in BCG-Treated Bladder Cancer Patients

Telomerase reverse transcriptase gene promoter (TERTp) mutations are recognized as one of the most frequent genetic events in bladder cancer (BC). No studies have focused on the relevance of TERTp mutations in the specific group of tumors treated with Bacillus Calmette&ndash
Gué
rin (BCG) intravesical therapy. Methods &mdash
125 non muscle invasive BC treated with BCG therapy (BCG-NMIBC) were screened for TERTp mutations, TERT rs2853669 single nucleotide polymorphism, and Fibroblast Growth Factor Receptor 3 (FGFR3) hotspot mutations. Results &mdash
TERTp mutations were found in 56.0% of BCG-NMIBC and were not associated with tumor stage or grade. FGFR3 mutations were found in 44.9% of the cases and were not associated with tumor stage or grade nor with TERTp mutations. The TERT rs2853669 single nucleotide polymorphism was associated with tumors of higher grade. The specific c.1-146G>
A TERTp mutation was an independent predictor of nonrecurrence after BCG therapy (hazard ratio&mdash
0.382
95% confidence interval&mdash
0.150&ndash
0.971, p = 0.048). Conclusions &mdash
TERTp mutations are frequent in BCG-NMIBC and -146G>
A appears to be an independent predictive marker of response to BCG treatment with an impact in recurrence-free survival.