Krishna Vanaja Donkena on Using Immune Markers to Predict Survival in Bladder Cancer

Krishna Vanaja Donkena, PhD, Assistant Professor of Biochemistry and Molecular Biology, Center for Individualized Medicine, Mayo Clinic, discusses using immune and checkpoint markers to predict cancer-specific survival in bladder cancer.

If the marker Foxp3 is expressed on the invasive margin region, it has very good significance in terms of prediction, says Donkena. The killer t-cell molecule CD8 is also a good predictor for cancer-specific survival.

Checkpoint molecules can also help predict survival, she says. PD-1, if it is expressed on the invasive margin region, is the best checkpoint marker for survival. IDO1 expression in the non-tumor region is also a good marker.

Using both the immune markers and the checkpoint markers, Donkena and her team at the Mayo Clinic have developed a combined score system. If a patient has a score of 8-12, for example, they have 0% risk of cancer-specific death. If a patient has a combined marker score of 0-4, then the risk of cancer-specific is death is high, says Donkena.