doctor holding urine sample

The University of Birmingham has partnered with Nonacus, a company that develops non-invasive genetic testing devices, to produce a urine test for bladder cancer that could spare thousands of people invasive procedures.

The test will combine Nonacus’ highly sensitive DNA-sensing technology with a set of unique DNA errors (mutations) found in the majority of bladder cancers identified by researchers funded by Cancer Research UK and the Medical Research Council.

By combining the two, they hope to produce a test that can detect these unique mutations in a person’s urine, which could be a sign of bladder cancer.

Chris Sale, chief executive of Nonacus Ltd, said: “We expect this partnership to deliver better care and outcomes for patients by reducing the number of invasive procedures, providing earlier diagnosis and speeding up access to treatment for people with bladder cancer.”

Sparing people unnecessary procedures

Over 100,000 people a year in the UK are referred to hospital clinics that investigate for bladder cancer, usually after seeing blood in their urine (haematuria). If referred, the first stage of investigation is usually a cystoscopy, which involves inserting a camera into the bladder.

Of these 100,000 patients, around 1 in 8 are subsequently diagnosed with bladder cancer, normally after a second invasive procedure to extract a biopsy.

Dr Rik Bryan, director of the University of Birmingham’s Bladder Cancer Research Centre, said while blood visible in the urine should always be investigated, we need a highly sensitive and specific, non-invasive test that can rapidly determine those who need a biopsy and those who do not, and a urine test is the obvious place to start.

Detecting cancer in pee

There are two main ways for cancer to end up urine – through the kidneys or from the bladder and ureters (the tubes that connect the kidneys to the bladder). Urine tests could become a simple way to look for cancers that affect these areas, but they also have potential for diagnosing pancreatic cancer at an early stage – something that could be key to improving survival for the disease.

Find out more about urine tests in our blog.

Pinpointing tell-tale signs of bladder cancer

Detecting cancer DNA in urine can be tricky because there’s a lot of other DNA from normal tissues that it can hide amongst, which is why you need highly sensitive tests that can accurately detect small amounts of specific pieces of DNA.

This is what Nonacus is providing, having developed ways of accurately detecting DNA for various scenarios, such as pre-natal blood tests.

But what you also need to know is what DNA to look for, which is where the researchers at the University of Birmingham come in.

Bryan and his colleague, Dr Douglas Ward, led a team that analysed 23 genes from tumour samples collected from 956 newly diagnosed bladder patients who hadn’t received treatment yet. They identified 451 unique mutations that were present in over 96% of tumours.

The researchers also demonstrated that these mutations were identifiable in urine samples collected at the same time as tumour sampling.

By collaborating with Nonacus, the team are hoping to be able to take this research and turn it into a practical test to improve the way we detect bladder cancer. Nonacus hope to make the test available next year.

Tony Hickson, chief business officer at Cancer Research UK, said: “Having Nonacus on board to help transform promising findings in the lab into a new non-invasive test to diagnosis bladder cancer is a testament to how commercial collaborations have the potential to transform the lives of patients. We are looking forward to seeing the next steps as the test is developed and rolled out to the UK and beyond.”

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