Department of Pharmacy, School of Health Sciences, University of Patras, Patras, Greece; Department of Radiation Oncology, University of Patras Medical School, Patras, Greece.
Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece.
EBioMedicine. 2018 Feb;28:43-50. doi: 10.1016/j.ebiom.2018.01.044. Epub 2018 Feb 2.
Unmet needs in urothelial cancer management represent an important challenge in our effort to improve long-term overall and disease-free survival rates with no significant compromise in quality of life. Radical cystectomy with pelvic lymph node dissection is the standard for the management of muscle-invasive, non-metastatic cancers. In spite of a 90% local disease control, up to 50% of patients ultimately die of distant metastasis. Bladder preservation using chemo-radiation is an acceptable alternative, but optimal patient selection remains elusive. Recent research is focused on the employment of tailored-made strategies in urothelial cancer exploiting the potential of theranostics in patient selection for specific therapies. Herein, we review the current knowledge on molecular theranostics in urothelial cancer and we suggest that this is the time to move toward imaging theranostics, if tailored-made disease management and patient stratification is envisaged.
在提高长期总生存率和无病生存率的同时，不显著降低生活质量，这是我们努力的目标，而尿路上皮癌管理中的未满足需求则代表着一个重要的挑战。根治性膀胱切除术加盆腔淋巴结清扫术是治疗肌层浸润性、非转移性癌症的标准方法。尽管局部疾病控制率达到了 90%，但仍有多达 50%的患者最终死于远处转移。采用放化疗保膀胱是一种可接受的替代方法，但最佳的患者选择仍难以捉摸。最近的研究集中在利用治疗诊断学在为特定治疗选择患者方面的潜力，针对尿路上皮癌采用量身定制的策略。在此，我们回顾了尿路上皮癌分子治疗诊断学的现有知识，并认为如果设想进行定制的疾病管理和患者分层，那么现在是转向成像治疗诊断学的时候了。
