Current and innovative approaches in the treatment of non-muscle invasive bladder cancer: the role of transurethral resection of bladder tumor and organoids

Abstract

BackgroundBladder cancer is the 7th most common cancer in men. About 75% of all bladder cancer are non-muscle invasive (NMIBC). The golden standard for definite diagnosis and first-line treatment of NMIBC is transurethral resection of bladder tumour (TURB). Historically, the monopolar current was used first, today bipolar current is preferred by most urologists. Following TURB, depending on the tumour grade, additional intravesical chemo- or/and immunotherapy is indicated, in order to prevent recurrence and need for surgical resection. Development of new technologies, molecular and cell biology, enabled scientists to develop organoids – systems of human cells that are cultivated in the laboratory and have characteristics of the tissue from which they were harvested. In the field of urologic cancers, the organoids are used mainly for studying the course of different diseases, however, in the field of bladder cancer the data are scarce.ConclusionsDifferent currents - monopolar and bipolar, have different effect on urothelium, that is important for oncological results and pathohistological interpretation. Specimens of bladder cancer can be used for preparation of organoids that are further used for studying carcinogenesis. Bladder organoids are step towards personalised medicine, especially for testing effectiveness of chemo-/immunotherapeutics.

Effect of intravesical chemotherapy on the survival of patients with non-muscle-invasive bladder cancer undergoing transurethral resection: a retrospective cohort study among older adults

“…17 Lower mortality among the patients that were diagnosed in 2015 could reflect higher adherence to the current treatment guidelines on administering chemotherapy as well as recent advances in bladder cancer therapies. [18][19][20] There are several limitations to our study. First, retrospective databases have the inherent selection bias even though we tried to control for confounders with matching.…”

The Golgi complex: An organelle that determines urothelial cell biology in health and disease

“…On the global level, incidence and mortality rates vary due to different methodologies and diagnostic practices. Approximately 25% of patients with bladder cancer present with muscle-invasive or metastatic disease, others have non-muscle invasive bladder cancer (NMIBC) (Taskovska et al 2020 ).…”

Current status of organoid culture in urological malignancy

“…Conversely, FGFR3 activation mutation is less frequent in high‐grade bladder cancer and MIBC, 8 therefore, organoids derived from these tumors displayed no significant response to trametinib and SCH772984 45 . Regarding frequent recurrence of bladder cancer after treatment with mitomycin C and BCG, 64 the derived organoids exhibited markedly greater resistance to a wide range of drugs 45 . Moreover, organoids can predict the effects and responses of combination therapies based on mutational profile.…”