Department of Surgery (Urology), Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Cedars-Sinai Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA, USA.
Nat Rev Cancer. 2021 Feb;21(2):104-121. doi: 10.1038/s41568-020-00313-1. Epub 2020 Dec 2.
The field of research in bladder cancer has seen significant advances in recent years. Next-generation sequencing has identified the genes most mutated in bladder cancer. This wealth of information allowed the definition of driver mutations, and identification of actionable therapeutic targets, as well as a clearer picture of patient prognosis and therapeutic direction. In a similar vein, our understanding of the cellular aspects of bladder cancer has grown. The identification of the cellular geography and the populations of different cell types and quantifications of normal and abnormal cell types in tumours provide a better prediction of therapeutic response. Non-invasive methods of diagnosis, including liquid biopsies, have seen major advances as well. These methods will likely find considerable utility in assessing minimal residual disease following treatment and for early-stage diagnosis. A significant therapeutic impact on patients with bladder cancer is found in the use of immune checkpoint inhibitor therapeutics. These therapeutics have been shown to cure some patients with bladder cancer and significantly decrease adverse events. These developments provide patients with better monitoring opportunities, unique therapeutic options and greater hope for prolonged survival.
近年来,膀胱癌研究领域取得了重大进展。下一代测序技术已经确定了膀胱癌中突变最频繁的基因。这些丰富的信息使得能够定义驱动突变,并确定可操作的治疗靶点,以及更清楚地了解患者的预后和治疗方向。同样,我们对膀胱癌细胞方面的认识也在不断增长。鉴定细胞地理学以及不同细胞类型的群体,并对肿瘤中的正常和异常细胞类型进行定量分析,为预测治疗反应提供了更好的依据。非侵入性诊断方法,包括液体活检,也取得了重大进展。这些方法很可能在评估治疗后微小残留疾病和早期诊断方面具有重要的应用价值。免疫检查点抑制剂治疗在膀胱癌患者中产生了显著的治疗效果。这些疗法已经证明可以治愈一些膀胱癌患者,并显著减少不良反应。这些进展为患者提供了更好的监测机会、独特的治疗选择和更长生存时间的更大希望。