Predictive Biomarkers in Bladder Cancer - Beyond the Abstract

Compared to other cancers such as non-small cell lung cancer (NSCLC) or melanoma, only a little progress in therapeutic options has been achieved in advanced bladder cancer until recently, immunotherapy and molecular targeted therapy approaches have closed the gap. Our knowledge about the molecular background of bladder cancer has additionally increased dramatically in the last few years mainly based on high-throughput transcriptomic studies from the TCGA-consortium and study groups mainly from the USA and Europe. As the nomenclature and taxonomy approaches vary between the different systems, a consensus-classification based on a comprehensive re-analysis of the dataset was recently published¹ hopefully paving the way to a more standardized analysis, reporting and research in molecular subtypes in urothelial muscle-invasive bladder cancer (MIBC). This is important especially as the molecular subtypes showed not only prognostic but also predictive value in chemotherapy and immunotherapy of advanced bladder cancer.

These welcomed recent advances in therapy and understanding of bladder cancer have led to a new dynamic also in the field of tissue-based biomarkers with relevance also for non-genitourinary pathologists. Aim of the present review² is to give an overview of the current state and future perspective of predictive biomarkers in urological oncology from the pathologist’s perspective. The article references a lecture event that took place at the 103^rd annual meeting of the German Society of Pathology (DGP) in Frankfurt, Germany during June 2019.

1. Kamoun, Aurélie, Aurélien de Reyniès, Yves Allory, Gottfrid Sjödahl, A. Gordon Robertson, Roland Seiler, Katherine A. Hoadley et al. "A consensus molecular classification of muscle-invasive bladder cancer." European urology (2019).
2. Reis, H., and T. Szarvas. "Therapieprädiktive Biomarker des Harnblasenkarzinoms." Der Pathologe 40, no. 3 (2019): 331-338.