New Strategies in Muscle-Invasive Bladder Cancer: On the Road to Personalized Medicine

Abstract

Bladder cancer remains one of the most deadly and expensive diseases affecting modern society. The options currently available to patients with muscle-invasive bladder cancer have remained essentially unchanged for the last generation. As the roles for surgery and chemotherapy in the management of this lethal disease have become better defined, so too have the limitations of these two treatment modalities. Despite the lack of groundbreaking clinical advances over the past two decades, recent years have witnessed a notable increase in the amount of promising preclinical and early translational research that will greatly improve our understanding of the molecular underpinnings of bladder cancer. If this momentum in bladder cancer research continues to build, it is likely that in the next 5 to 10 years we will be able to achieve our goal of bringing bladder cancer treatment into the age of personalized medicine.

Suppression of progranulin expression inhibits bladder cancer growth and sensitizes cancer cells to cisplatin

“…There is a great interest at the moment in the identification of novel biomarkers for prognosis and treatment selection of advanced bladder cancers [39–41]. Recent work has identified subtypes of muscle-invasive bladder tumors, basal, luminal and p53-like that resemble molecular subtypes of breast cancer [41–44].…”

Resiniferatoxin induces death of bladder cancer cells associated with mitochondrial dysfunction and reduces tumor growth in a xenograft mouse model

“…Although transurethral resection (TUR) of TCC of the bladder induces an 80% early success rate, nearly 70% of these patients will develop tumor recurrence, with 25% showing progression to muscle-invasive disease within 5 years with TUR. Intravesical chemotherapy and immunotherapy are widely used as adjuvant therapies after TUR to prevent recurrence and progression of superficial disease, but meta-analysis does not show apparent superiority of a particular treatment [20,21]. For this reason it is fundamental to develop optimal, less toxic chemotherapy regimens by incorporating novel targeted agents to improve the outcomes.…”

The Estrogen Pathway: Estrogen Receptor-α, Progesterone Receptor, and Estrogen Receptor-β Expression in Radical Cystectomy Urothelial Cell Carcinoma Specimens

“…Recurrences, frequently as metastatic disease, are common in approximately one third of patients. 3 Patients with distant metastases rarely achieve complete remission with combination chemotherapy.…”