Bladder cancer
Molecular diagnostics in the era of targeted therapies for mUCa

Jasmine (70 years old)

Jasmine, 70 years old, spends her days volunteering at the local food bank, distributing meals to those in need. Unfortunately, she was diagnosed with muscle-invasive bladder cancer (MIBC), for which she received 4 cycles of neoadjuvant gemcitabine + cisplatin before radical cystectomy (RC) 6 months ago.

Assessment summary:

  • ECOG PS: 1
  • Medical history: Hashimoto’s thyroiditis, rheumatoid arthritis
  • TURBT at initial diagnosis: minimal pT2 UCa cN0M0
  • Pathological review RC specimen: ypT2 ypN+ (3/18), lymphatic and vascular invasion, negative surgical margins

A recent CT scan showed new bilateral pulmonary nodes.

  • Pathological review of pulmonary node biopsy: confirmed a UCa metastasis

Her oncologist suggests testing FGFR3 alterations for further treatment decisions.

Which of the following sample types would you choose for testing FGFR3 alterations in this patient?