Hope and challenge: Precision medicine in bladder cancer

Abstract

Bladder cancer (BC) is a complex disease and could be classified into nonmuscle‐invasive BC (NMIBC) or muscle‐invasive BC (MIBC) subtypes according to the distinct genetic background and clinical prognosis. Until now, the golden standard and confirmed diagnosis of BC is cystoscopy and the major problems of BC are the high rate of recurrence and high costs in the clinic. Recent molecular and genetic studies have provided perspectives on the novel biomarkers and potential therapeutic targets of BC. In this article, we provided an overview of the traditional diagnostic approaches of BC, and introduced some new imaging, endoscopic, and immunological diagnostic technology in the accurate diagnosis of BC. Meanwhile, the minimally invasive precision treatment technique, immunotherapy, chemotherapy, gene therapy, and targeted therapy of BC were also included. Here, we will overview the diagnosis and therapy methods of BC used in clinical practice, focusing on their specificity, efficiency, and safety. On the basis of the discussion of the benefits of precision medicine in BC, we will also discuss the challenges and limitations facing the non‐invasive methods of diagnosis and precision therapy of BC. The molecularly targeted and immunotherapeutic approaches, and gene therapy methods to BC treatment improved the prognosis and overall survival of BC patients.

Role of Exosomal miRNA in Bladder Cancer: A Promising Liquid Biopsy Biomarker

“…For decades, a combination of cytology and cystoscopy has been used routinely for the diagnosis, prognosis, and surveillance of bladder cancer (BCa); however, several outstanding issues remain. Specifically, the poor sensitivity of cytology in detecting BCa, the high invasiveness of cystoscopy, and the substantial inter- and intra-observer variations in tumor stage and grade interpretation emphasize the urgent need for improvements in BCa clinical guidance [ 2 ].…”

Integrative Metabolomic and Transcriptomic Analysis for the Study of Bladder Cancer

“…Nowadays, cystoscopy and urinary cytology are the gold standards for BC diagnosis and follow-up [5]. However, urinary cytology has low sensitivity in low grade tumors detection and cystoscopy is invasive, expensive, operator-dependent [5], and has limitations in the differentiation between inflammation and malignancy and in the diagnosis of CIS, which is considered tumors at high risk of progression [6]. In this scenario, the development of non-invasive strategies for the improvement of early diagnosis and detection of recurrences in the follow-up is of importance.…”

Urinary Metabolic Signatures Detect Recurrences in Non-Muscle Invasive Bladder Cancer

“…Cystoscopy and urinary cytology are routinely used for BC diagnosis and surveillance. Nevertheless, both of them present limitations, including issues related to accuracy in the detection of low-grade tumors, omission of CIS and pre-neoplasic lesions, invasiveness, and high costs [4,5,6].…”