Genomic and Therapeutic Landscape of Non-muscle-invasive Bladder Cancer

Urol Clin North Am. 2020 Feb;47(1):35-46. doi: 10.1016/j.ucl.2019.09.006.

Abstract

Non-muscle-invasive bladder cancer (NMIBC) is heterogeneous, but current diagnostic and treatment strategies rely primarily on clinical parameters, lacking individualization to tumor and host genetics and biology. The heterogeneity of NMIBCs is derived from mutations, mutation signatures, chromosomal loss, and disruption of molecular pathways, which ultimately affects tumor progression, recurrence, and responsiveness to intravesical and systemic chemotherapy. Although research is still underway, advances in sequencing technology, insight into differential bacillus Calmette-Guérin responses, and new investigational treatment targets will soon offer clinicians new, precision-based tools to risk stratify and determine treatment regimens for future patients with bladder cancer.

Keywords: BCG; Bladder cancer; Genomics; Immunotherapy; Mutation.

Publication types

  • Review

MeSH terms

  • Adjuvants, Immunologic / administration & dosage
  • Administration, Intravesical
  • BCG Vaccine / administration & dosage*
  • Biomarkers, Tumor / genetics*
  • Biomarkers, Tumor / metabolism
  • DNA Mutational Analysis
  • DNA, Neoplasm / genetics*
  • Disease Progression
  • Genomics / methods*
  • Humans
  • Immunotherapy / methods*
  • Mutation*
  • Neoplasm Invasiveness
  • Urinary Bladder Neoplasms / drug therapy
  • Urinary Bladder Neoplasms / genetics*
  • Urinary Bladder Neoplasms / pathology

Substances

  • Adjuvants, Immunologic
  • BCG Vaccine
  • Biomarkers, Tumor
  • DNA, Neoplasm