Germline homologous recombination repair (gHRR) variants in bladder cancer: Preliminary evidence and clinical implications

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Autores principales: Rodolfo Hurle, Anita Capalbo, Giovanni Lughezzani, Nicolò Maria Buffi, Francesco Sormani, Alessio Finocchiaro, Alberto Saita, Marco Paciotti, Vittorio Fasulo, Pietro Cavalli, Paolo Bianchi, Alessio Benetti, Pier Paolo Avolio, Rosanna Asselta, Giulia Soldà, Paolo Casale, Massimo Lazzeri
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Publicado: Wiley 2025
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author Rodolfo Hurle
Anita Capalbo
Giovanni Lughezzani
Nicolò Maria Buffi
Francesco Sormani
Alessio Finocchiaro
Alberto Saita
Marco Paciotti
Vittorio Fasulo
Pietro Cavalli
Paolo Bianchi
Alessio Benetti
Pier Paolo Avolio
Rosanna Asselta
Giulia Soldà
Paolo Casale
Massimo Lazzeri
author_facet Rodolfo Hurle
Anita Capalbo
Giovanni Lughezzani
Nicolò Maria Buffi
Francesco Sormani
Alessio Finocchiaro
Alberto Saita
Marco Paciotti
Vittorio Fasulo
Pietro Cavalli
Paolo Bianchi
Alessio Benetti
Pier Paolo Avolio
Rosanna Asselta
Giulia Soldà
Paolo Casale
Massimo Lazzeri
Rodolfo Hurle
Anita Capalbo
Giovanni Lughezzani
Nicolò Maria Buffi
Francesco Sormani
Alessio Finocchiaro
Alberto Saita
Marco Paciotti
Vittorio Fasulo
Pietro Cavalli
Paolo Bianchi
Alessio Benetti
Pier Paolo Avolio
Rosanna Asselta
Giulia Soldà
Paolo Casale
Massimo Lazzeri
collection Wiley Open Access
contents Germline homologous recombination repair (gHRR) variants in bladder cancer: Preliminary evidence and clinical implications Rodolfo Hurle Anita Capalbo Giovanni Lughezzani Nicolò Maria Buffi Francesco Sormani Alessio Finocchiaro Alberto Saita Marco Paciotti Vittorio Fasulo Pietro Cavalli Paolo Bianchi Alessio Benetti Pier Paolo Avolio Rosanna Asselta Giulia Soldà Paolo Casale Massimo Lazzeri BJUI Compass Abstract Objective The contribution of germline DNA repair gene (gDRG) variants to bladder cancer (BC) susceptibility and progression is still poorly defined, particularly in European populations. This study aims to evaluate the prevalence and clinical implications of germline homologous recombination repair (HRR) gene variants in BC patients of European ancestry. Methods In this prospective case–control study, 75 BC patients attending follow‐up at a single tertiary centre were screened for germline variants in 20 gDRGs. Patients were included regardless of disease stage and classified by pathogenicity (Class 3–5). Clinical characteristics and outcomes were compared between variant‐positive and variant‐negative patients. Results Among 75 eligible patients, 72 underwent successful germline sequencing. A total of 23 patients (30.6%) harboured at least one pathogenic, likely pathogenic, or VUS variant. The most frequently altered genes included ATM ( n  = 6), ATR ( n  = 4), BARD1 ( n  = 4), CHEK2 ( n  = 3) and PMS2 ( n  = 3). Eight patients (34.7%) had multiple variants, and one carried three variants. Notably, 25.8% of NMIBC and 50% of MIBC patients had gDRG variants. Moreover, 30% of patients with low‐grade G1 disease harboured at least one variant. Patients with gDRG variants had a higher rate of histopathological variants (34.8% vs. 13.5%) and underwent radical cystectomy at a younger age (60 vs. 75 years, p  < 0.05). Conclusions Germline HRR variants are prevalent in BC patients and may influence disease aggressiveness and treatment decisions. These findings support broader implementation of germline testing in BC and warrant further validation in larger cohorts. 10.1002/bco2.70077 http://creativecommons.org/licenses/by/4.0/
doi_str_mv 10.1002/bco2.70077
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publisher Wiley
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spellingShingle Germline homologous recombination repair (gHRR) variants in bladder cancer: Preliminary evidence and clinical implications
Rodolfo Hurle
Anita Capalbo
Giovanni Lughezzani
Nicolò Maria Buffi
Francesco Sormani
Alessio Finocchiaro
Alberto Saita
Marco Paciotti
Vittorio Fasulo
Pietro Cavalli
Paolo Bianchi
Alessio Benetti
Pier Paolo Avolio
Rosanna Asselta
Giulia Soldà
Paolo Casale
Massimo Lazzeri
BJUI Compass
Germline homologous recombination repair (gHRR) variants in bladder cancer: Preliminary evidence and clinical implications Rodolfo Hurle Anita Capalbo Giovanni Lughezzani Nicolò Maria Buffi Francesco Sormani Alessio Finocchiaro Alberto Saita Marco Paciotti Vittorio Fasulo Pietro Cavalli Paolo Bianchi Alessio Benetti Pier Paolo Avolio Rosanna Asselta Giulia Soldà Paolo Casale Massimo Lazzeri BJUI Compass Abstract Objective The contribution of germline DNA repair gene (gDRG) variants to bladder cancer (BC) susceptibility and progression is still poorly defined, particularly in European populations. This study aims to evaluate the prevalence and clinical implications of germline homologous recombination repair (HRR) gene variants in BC patients of European ancestry. Methods In this prospective case–control study, 75 BC patients attending follow‐up at a single tertiary centre were screened for germline variants in 20 gDRGs. Patients were included regardless of disease stage and classified by pathogenicity (Class 3–5). Clinical characteristics and outcomes were compared between variant‐positive and variant‐negative patients. Results Among 75 eligible patients, 72 underwent successful germline sequencing. A total of 23 patients (30.6%) harboured at least one pathogenic, likely pathogenic, or VUS variant. The most frequently altered genes included ATM ( n  = 6), ATR ( n  = 4), BARD1 ( n  = 4), CHEK2 ( n  = 3) and PMS2 ( n  = 3). Eight patients (34.7%) had multiple variants, and one carried three variants. Notably, 25.8% of NMIBC and 50% of MIBC patients had gDRG variants. Moreover, 30% of patients with low‐grade G1 disease harboured at least one variant. Patients with gDRG variants had a higher rate of histopathological variants (34.8% vs. 13.5%) and underwent radical cystectomy at a younger age (60 vs. 75 years, p  < 0.05). Conclusions Germline HRR variants are prevalent in BC patients and may influence disease aggressiveness and treatment decisions. These findings support broader implementation of germline testing in BC and warrant further validation in larger cohorts. 10.1002/bco2.70077 http://creativecommons.org/licenses/by/4.0/
title Germline homologous recombination repair (gHRR) variants in bladder cancer: Preliminary evidence and clinical implications
topic BJUI Compass
url https://bjui-journals.onlinelibrary.wiley.com/doi/10.1002/bco2.70077