Department of Urology, Comprehensive Cancer Center.
Center for Cancer Research and Comprehensive Cancer Center, Medical University of Vienna, Austria.
Curr Opin Urol. 2024 Jul 1;34(4):251-257. doi: 10.1097/MOU.0000000000001177. Epub 2024 Apr 10.
Bladder cancer incidence is on the rise, and until recently, there has been little to no change in treatment regimens over the last 40 years. Hence, it is imperative to work on strategies and approaches to untangle the complexity of intra- and inter-tumour heterogeneity of bladder cancer with the aim of improving patient-specific care and treatment outcomes. The focus of this review is therefore to highlight novel targets, advances, and therapy approaches for bladder cancer patients.
The success of combining an antibody-drug conjugate (ADC) with immunotherapy has been recently hailed as a game changer in treating bladder cancer patients. Hence, interest in other ADCs as a treatment option is also rife. Furthermore, strategies to overcome chemoresistance to standard therapy have been described recently. In addition, other studies showed that targeting genomic alterations (e.g. mutations in FGFR3 , DNA damage repair genes and loss of the Y chromosome) could also be helpful as prognostic and treatment stratification biomarkers. The use of single-cell RNA sequencing approaches has allowed better characterisation of the tumour microenvironment and subsequent identification of novel targets. Functional precision medicine could be another avenue to improve and guide personalized treatment options.
Several novel preclinical targets and treatment options have been described recently. The validation of these advances will lead to the development and implementation of robust personalized treatment regimens for bladder cancer patients.
膀胱癌的发病率正在上升,在过去的 40 年中,治疗方案几乎没有变化。因此,必须制定策略和方法来解决膀胱癌的内在和肿瘤间异质性的复杂性,以期改善患者的个体化护理和治疗效果。因此,本篇综述的重点是强调膀胱癌患者的新靶点、新进展和治疗方法。
抗体药物偶联物(ADC)与免疫疗法的联合应用的成功最近被誉为治疗膀胱癌患者的变革者。因此,人们对其他 ADC 作为治疗选择也很感兴趣。此外,最近还描述了克服对标准治疗的化疗耐药性的策略。此外,其他研究表明,靶向基因组改变(例如 FGFR3 突变、DNA 损伤修复基因和 Y 染色体缺失)也可能作为预后和治疗分层的生物标志物。单细胞 RNA 测序方法的使用允许更好地描述肿瘤微环境,并随后确定新的靶点。功能性精准医学可能是另一种改善和指导个体化治疗方案的途径。
最近描述了几个新的临床前靶点和治疗选择。这些进展的验证将导致为膀胱癌患者开发和实施强大的个体化治疗方案。