Waiting in the wings: the emerging role of molecular biomarkers in bladder cancer

Expert Rev Mol Diagn. 2018 Apr;18(4):347-356. doi: 10.1080/14737159.2018.1453808. Epub 2018 Mar 21.

Abstract

Bladder cancer (BCa) is the fifth most frequently diagnosed cancer worldwide and is, in fact, the most expensive cancer on a per-patient to treat basis. There is a critical need to implement new tests into clinical practice to improve the quality of clinical care, decrease unnecessary invasive therapies and ultimately save costs. Currently, no molecular or genetic biomarker has been widely integrated into daily clinical practice. However, major milestones have been achieved in our understanding of the molecular alterations in BCa that will provide the basis for integrating molecular and genetic biomarkers into clinical decision making to guide management. Clinical implementation of such novel molecular and genetic concepts is the cornerstone in an effort to usher the age of precision medicine into patient care. Areas covered: In this review, the authors discuss the emerging role of molecular biomarkers in patients receiving BCG immunotherapy as well as neoadjuvant and adjuvant chemotherapy in BCa. Expert commentary: Molecular predictive and prognostic biomarkers in BCa are promising diagnostic options that will pave the way for molecular-based personalized medicine.

Keywords: BCG therapy; bladder cancer; molecular biomarker; neoadjuvant therapy; personalized medicine; predictive biomarker; prognostic biomarker.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents / therapeutic use
  • BCG Vaccine / immunology
  • BCG Vaccine / therapeutic use
  • Biomarkers, Tumor* / blood
  • Biomarkers, Tumor* / genetics
  • Chemotherapy, Adjuvant
  • Cisplatin / therapeutic use
  • Epigenesis, Genetic
  • Humans
  • Neoadjuvant Therapy
  • Precision Medicine
  • Urinary Bladder Neoplasms / diagnosis
  • Urinary Bladder Neoplasms / drug therapy
  • Urinary Bladder Neoplasms / therapy*

Substances

  • Antineoplastic Agents
  • BCG Vaccine
  • Biomarkers, Tumor
  • Cisplatin