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ASCO 2024 | GUSTO: use of gene expression patterns to identify unique molecular subtypes in MIBC

Simon Crabb, PhD, MBBS, University of Southampton, Southampton, UK, discusses the GUSTO trial, a study focused on improving outcomes for muscle-invasive bladder cancer (MIBC) through subtype-guided treatment allocation. MIBC is an aggressive disease with poor survival rates, and many patients do not respond to standard chemotherapy or immunotherapy. The GUSTO trial aims to optimize treatment by using gene expression patterns to classify MIBC into molecular subtypes, which respond differently to treatments. Eligible patients with non-metastatic MIBC are randomized to either standard care or subtype-guided treatment based on gene expression analysis. The trial has three stages: assessing feasibility, confirming recruitment assumptions, and evaluating treatment outcomes based on molecular subtypes. Recruitment began in September 2023, with the study seeking to enroll 320 patients. This interview took place during the 2024 American Society of Clinical Oncology (ASCO) Meeting in Chicago, IL.

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