Cancer Treatment Today

There is no literature support on whether molecular testing helps to manage squamous cell carcinoma, and it is not generally disigned to distinguish the source of the disease or bwteeen primary and secondary disease
Tempus xT-DNA is presented as a targeted panel of 648 genes enriched for clinically relevant genes and most commonly mutated cancer driver genes with additional genes of emerging clinical significance focused on immediately actionable mutations. However, 648 genes cannot possibly be all actionable. In addition, it uses a different technology than commonly available NGS. Tempus analyzes the DNA, RNA, and specific proteins of cancer cells to understand the patient’s disease at the molecular level so it can identify personalized treatment options designed to specifically target their unique cancer. As such, it requires a significantly higher burden of proof before being widely accepted. Proudman et al concluded that replacing 20% of usual testing with Tempus xT CGP was associated with a small incremental testing cost and can identify meaningfully more actionable alterations.
However these considerations do not apply to squamous cell bladder cacner. Pure squamous cell carcinoma (SCC) is the most common pure variant form of bladder cancer, found in 2–5% of cases. It often presents late and is unresponsive to cisplatin based chemotherapy. The molecular features of these tumours have not been elucidated in detail.

Jagtap SV, Sarda SD, Demde RB, Huddedar AD, Jagtap SS. Primary Squamous Cell Carcinoma of Urinary Bladder – A Rare Histological Variant. J Clin Diagn Res. 2015 Nov;9(11):ED03-4.

Hurst CD, Cheng G, Platt FM, Alder O, Black EV, Burns JE, Brown J, Jain S, Roulson JA, Knowles MA. Molecular profile of pure squamous cell carcinoma of the bladder identifies major roles for OSMR and YAP signalling. J Pathol Clin Res. 2022 May;8(3):279-293.

NCCN Bladder Cancer 2023