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Prospective pilot and feasibility study of a blood-based biomarker of aging in patients with invasive bladder cancer undergoing radical cystectomy
Benjamin T. Ristau, MD, MHA1, Chia-Ling Kuo, PhD2, Shangshu Zhao, PhD2, Laura Haynes, PhD2, George A. Kuchel, MD2.
1UConn Health, Farmington, CT, USA, 2University of Connecticut Health Center, Farmington, CT, USA.
Introduction:Bladder cancer is a disease of older adults with a median age at diagnosis of 73 years. Marked heterogeneity in physiologic aging and frailty - beyond chronologic age - has been observed in patients diagnosed with invasive bladder cancer. However, these differences are poorly captured in clinical practice making personalized treatment decisions difficult. We report a prospective pilot study to assess the feasibility of collecting clinical frailty data and comparing it to a novel blood-based biomarker of aging: the senescence-associated secretory phenotype (SASP) score.
Materials & Methods:12 patients diagnosed with invasive bladder cancer were prospectively recruited to participate in this IRB-approved study. Patients underwent physical frailty assessment (Fried frailty phenotype) and provided blood for biomarker analysis prior to treatment. The SASP score is a composite of 38 plasma proteins linked to cellular senescence and was measured via Luminex assay and Meso Scale Discovery (MSD) platforms. Coefficient of determination (rē) was calculated. P < 0.05 was considered statistically significant.
Results:8/12 patients had Fried frailty and SASP scores available for this analysis: median age 72 years, range 63-86; 6 male, 2 female. Four patients were characterized as not frail and four patients as frail on Fried frailty phenotype. Median SASP score was 72.66 (range 65.63-78.11). Chronologic age explained only 53% of the variance in SASP score (rē = 0.53, p = 0.04, Figure 1). Fried frailty phenotype was not correlated with age nor SASP score in this small cohort.
Discussion:In patients undergoing radical cystectomy for invasive bladder cancer, collection of frailty data and comparison to novel blood-based biomarkers of aging is feasible. Even in this small cohort, SASP scores increased with age. Larger studies are required to determine the utility of incorporating biomarkers of aging into clinical decision-making.
Funding: P30AG067988, UConn Pepper Center REC Award
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