Wilson Fiona, Joseph Nuradh, Choudhury Ananya
The Christie NHS Foundation Trust, Manchester, United Kingdom.
Ministry of Health, Colombo, Sri Lanka; Sri Lanka Cancer Research Group, Colombo, Sri Lanka.
Adv Clin Chem. 2022;107:265-297. doi: 10.1016/bs.acc.2021.07.005. Epub 2021 Sep 10.
Muscle invasive bladder cancer (MIBC) carries a poor prognosis with a 5-year overall survival rate of 40-50%. For localized disease, radical treatment options are cystectomy or radiotherapy with or without a radiosensitiser. Neoadjuvant or adjuvant chemotherapy is often delivered in addition to either. Metastatic disease can be treated with palliative systemic chemotherapy or immunotherapy. Standard clinicopathological information is insufficient to guide treatment decisions in several clinical scenarios in MIBC and there has been substantial effort to identify predictive and prognostic biomarkers. Despite this, no biomarker has been sufficiently qualified in prospective clinical trials to justify routine use. In this chapter we discuss these biomarkers and provide insight into the significant unmet need for robust biomarkers to inform treatment decisions and ultimately improve outcomes for bladder cancer patients.
肌肉浸润性膀胱癌（MIBC）预后较差，5年总生存率为40%-50%。对于局限性疾病，根治性治疗方案为膀胱切除术或放疗，可联合或不联合放射增敏剂。新辅助或辅助化疗通常会在此基础上进行。转移性疾病可采用姑息性全身化疗或免疫治疗。在MIBC的几种临床情况下，标准的临床病理信息不足以指导治疗决策，因此人们一直在努力寻找预测性和预后性生物标志物。尽管如此，尚无生物标志物在前瞻性临床试验中得到充分验证，足以证明其可常规使用。在本章中，我们将讨论这些生物标志物，并深入探讨对可靠生物标志物的重大未满足需求，以指导治疗决策并最终改善膀胱癌患者的治疗效果。
