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Molecular Targeted Therapy of Bladder Cancer

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Precision Molecular Pathology of Bladder Cancer

Part of the book series: Molecular Pathology Library ((MPLB))

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Abstract

The modern treatment of advanced urothelial carcinoma has been built on the foundation of platinum-containing combination chemotherapy. This therapeutic approach has been in place with little change in several decades. Urothelial carcinoma possesses a high prevalence of therapeutic targets including: Vascular Endothelial Growth Factor Receptor (VEGFR), Human Epidermal Growth Factor Receptor 2 (HER2), Fibroblast Growth Factor Receptor (FGFR), among other pathways. Despite this target-rich environment, there are currently no molecularly targeted therapies in regular clinical use for the treatment of advanced urothelial carcinoma. Active clinical investigations, including randomized, phase 3 trials targeting these pathways are underway and will provide definitive results to these approaches. Recent genetic characterization of bladder cancer has provided new insights into the molecular-drivers of the disease and established new classification schemas, which may aid in our improved understanding of the disease and provide additional molecular targets. These newly characterized molecularly derived subtypes show similarities between subsets of bladder cancer patients and other cancer types such as lung and breast cancer. Several predictive biomarkers have been developed in bladder cancer including those based on gene expression signatures and single nucleotide polymorphisms (SNP), with the application of these approaches currently in active clinical investigation. With the recent approval of immune checkpoint inhibitor therapy for advanced bladder cancer, more attention is now being paid to therapeutic needs and opportunities in this disease. This, coupled with advances in molecular characterization of bladder cancer, presents a great opportunity for drug development and the rational integration of targeted agents in the care of bladder cancer patients.

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  1. University of Colorado School of Medicine, 13001 E 17th Pl, Aurora, CO, 80045, USA

    Elizabeth R. Kessler, Dan Theodorescu & Thomas W. Flaig

  2. University of Colorado Cancer Center, 1665 Aurora Ct, Aurora, CO, 80045, USA

    Elizabeth R. Kessler, Dan Theodorescu & Thomas W. Flaig

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  2. Dan Theodorescu
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Correspondence to Thomas W. Flaig .

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  1. Department of Pathology, University of California San Diego, San Diego, California, USA

    Donna E. Hansel

  2. Scott Department of Urology, Baylor College of Medicine, Houston, Texas, USA

    Seth P. Lerner

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Kessler, E.R., Theodorescu, D., Flaig, T.W. (2018). Molecular Targeted Therapy of Bladder Cancer. In: Hansel, D., Lerner, S. (eds) Precision Molecular Pathology of Bladder Cancer. Molecular Pathology Library. Springer, Cham. https://doi.org/10.1007/978-3-319-64769-2_9

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