Molecular substratification of bladder cancer: moving towards individualized patient management

Abstract

Despite advances in surgical techniques, perioperative therapies and postoperative management, outcomes for patients with bladder cancer have largely remained unchanged. Current management of bladder cancer still relies on pathologic staging that does not always reflect the risk for an individual patient. Studies assessing molecular alterations in individual tumors are offering insights into the myriad of cellular pathways that are deregulated in bladder tumorigenesis and progression. Alterations in pathways involved in cell-cycle regulation, apoptosis, cell signaling, angiogenesis and tumor-cell invasion have been shown to influence disease behavior. High-throughput assays are now allowing multiplexed assessment of biomarker alterations, thereby enabling characterization of novel molecular subtypes of bladder cancer. Such approaches have also been used for discovery and validation of robust prognostic molecular signatures. The future of bladder cancer management will rely on the use of validated multimarker panels for risk stratification, optimal surgical management, and theranostic strategies to identify and target specific alterations in individual tumors.

Critical Overview of HER2 Assessement in Bladder Cancer: What Is Missing for a Better Therapeutic Approach?

“…Several reasons contribute to these unresolved issues in bladder cancer the most important of them being the unproper technical approach used for HER2 assessement together with a lack of a well standardised protocol of its interpretation specifically for bladder cancers overexpressing HER2. Our results sustain an extensive revision of HER2 assessement protocols in bladder based on criteria regarding immunohistochemical and in situ hybridisation use and interpretation as effective tools for HER2 validation as a molecular marker in urothelial cancer subtyping, an issue recently and frequently discussed (43,44,45).…”

Prognostic Value of c-Myc Immunohistochemical Expression in Muscle Invasive Urothelial Carcinoma of the Urinary Bladder: A Retrospective Study

“…Prognosis of MIUC is related to various pathological and clinical parameters and the most powerful prognostic factor is the pathological stage. Although these prognostic factors represent significant predictors, they do not provide accurate predictions for individual patients (Kucuk et al, 2015;Mitra, 2016).…”

miR‑214 reduces cisplatin resistance by targeting netrin‑1 in bladder cancer cells

“…There are several risk factors for bladder cancer, including smoking, environmental and occupational exposure and gender (5). Although combined therapies, including surgery and chemotherapy, have been developed over the past decades, the prognosis for bladder cancer in the advanced stage remains poor (6). The identification of novel molecular targets and therapeutic strategies are required in order to achieve long-term survival of patients.…”