Current therapeutic strategies for invasive and metastatic bladder cancer

Prakash Vishnu, Jacob Mathew, Winston Tan

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Background: Bladder cancer is one of the most common cancers in Europe, the United States, and Northern African countries. Muscle-invasive bladder cancer is an aggressive epithelial tumor, with a high rate of early systemic dissemination. Superficial, noninvasive bladder cancer can most often be cured; a good proportion of invasive cases can also be cured by a combined modality approach of surgery, chemotherapy, and radiation. Recurrences are common and mostly manifest as metastatic disease. Those with distant metastatic disease can sometime achieve partial or complete remission with combination chemotherapy. Recent developments: Better understanding of the biology of the disease has led to the incorporation of molecular and genetic features along with factors such as tumor grade, lymphovascular invasion, and aberrant histology, thereby allowing identification of 'favorable' and 'unfavorable' cancers which helps a more accurate informed and objective selection of patients who would benefit from neoadjuvant and adjuvant chemotherapy. Gene expression profiling has been used to find molecular signature patterns that can potentially be predictive of drug sensitivity and metastasis. Understanding the molecular pathways of invasive bladder cancer has led to clinical investigation of several targeted therapeutics such as anti-angiogenics, mTOR inhibitors, and anti-EGFR agents. Conclusion: With improvements in the understanding of the biology of bladder cancer, clinical trials studying novel and targeted agents alone or in combination with chemotherapy have increased the armamentarium for the treatment of bladder cancer. Although the novel biomarkers and gene expression profiles have been shown to provide important predictive and prognostic information and are anticipated to be incorporated in clinical decision-making, their exact utility and relevance calls for a larger prospective validation.

Original languageEnglish (US)
Pages (from-to)97-113
Number of pages17
JournalOncoTargets and Therapy
Volume4
DOIs
StatePublished - 2011

Fingerprint

Urinary Bladder Neoplasms
Combination Drug Therapy
Neoplasms
Therapeutics
Angiogenesis Inhibitors
Gene Expression Profiling
Adjuvant Chemotherapy
Transcriptome
Patient Selection
Molecular Biology
Histology
Biomarkers
Clinical Trials
Radiation
Neoplasm Metastasis
Recurrence
Drug Therapy
Muscles
Pharmaceutical Preparations

Keywords

  • Biologic therapy
  • Bladder cancer
  • Chemotherapy
  • Neoadjuvant
  • PI3kinase/mTOR pathway

ASJC Scopus subject areas

  • Oncology
  • Pharmacology (medical)

Cite this

Current therapeutic strategies for invasive and metastatic bladder cancer. / Vishnu, Prakash; Mathew, Jacob; Tan, Winston.

In: OncoTargets and Therapy, Vol. 4, 2011, p. 97-113.

Research output: Contribution to journalArticle

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