Evolution of Urothelial Bladder Cancer in the Context of Molecular Classifications

Bladder cancer is a heterogeneous disease that is not depicted by current classification systems. It was originally classified into non-muscle invasive and muscle invasive. However, clinically and genetically variable tumors are summarized within both classes. A definition of three groups may better...

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Published inInternational journal of molecular sciences Vol. 21; no. 16; p. 5670
Main Authors Minoli, Martina, Kiener, Mirjam, Thalmann, George N., Kruithof-de Julio, Marianna, Seiler, Roland
Format Journal Article
LanguageEnglish
Published Switzerland MDPI AG 07.08.2020
MDPI
Subjects
Animals
Biomarkers
Biomarkers, Tumor - genetics
Bladder cancer
Cancer therapies
Chemotherapy
FDA approval
Humans
Medical prognosis
Metastasis
Muscles - pathology
Review
Surveillance
Treatment Failure
Tumors
Urinary Bladder Neoplasms - classification
Urinary Bladder Neoplasms - genetics
Urinary Bladder Neoplasms - therapy
Urothelium - pathology
molecular subtypes
non-muscle invasive
targeted therapy
bladder cancer
muscle invasive
evolution
classification
Online AccessGet full text
ISSN1422-0067
1661-6596
1422-0067
DOI10.3390/ijms21165670

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Abstract Bladder cancer is a heterogeneous disease that is not depicted by current classification systems. It was originally classified into non-muscle invasive and muscle invasive. However, clinically and genetically variable tumors are summarized within both classes. A definition of three groups may better account for the divergence in prognosis and probably also choice of treatment. The first group represents mostly non-invasive tumors that reoccur but do not progress. Contrarily, the second group represent non-muscle invasive tumors that likely progress to the third group, the muscle invasive tumors. High throughput tumor profiling improved our understanding of the biology of bladder cancer. It allows the identification of molecular subtypes, at least three for non-muscle invasive bladder cancer (Class I, Class II and Class III) and six for muscle-invasive bladder cancer (luminal papillary, luminal non-specified, luminal unstable, stroma-rich, basal/squamous and neuroendocrine-like) with distinct clinical and molecular phenotypes. Molecular subtypes can be potentially used to predict the response to treatment (e.g., neoadjuvant chemotherapy and immune checkpoint inhibitors). Moreover, they may allow to characterize the evolution of bladder cancer through different pathways. However, to move towards precision medicine, the understanding of the biological meaning of these molecular subtypes and differences in the composition of cell subpopulations will be mandatory.
AbstractList Bladder cancer is a heterogeneous disease that is not depicted by current classification systems. It was originally classified into non-muscle invasive and muscle invasive. However, clinically and genetically variable tumors are summarized within both classes. A definition of three groups may better account for the divergence in prognosis and probably also choice of treatment. The first group represents mostly non-invasive tumors that reoccur but do not progress. Contrarily, the second group represent non-muscle invasive tumors that likely progress to the third group, the muscle invasive tumors. High throughput tumor profiling improved our understanding of the biology of bladder cancer. It allows the identification of molecular subtypes, at least three for non-muscle invasive bladder cancer (Class I, Class II and Class III) and six for muscle-invasive bladder cancer (luminal papillary, luminal non-specified, luminal unstable, stroma-rich, basal/squamous and neuroendocrine-like) with distinct clinical and molecular phenotypes. Molecular subtypes can be potentially used to predict the response to treatment (e.g., neoadjuvant chemotherapy and immune checkpoint inhibitors). Moreover, they may allow to characterize the evolution of bladder cancer through different pathways. However, to move towards precision medicine, the understanding of the biological meaning of these molecular subtypes and differences in the composition of cell subpopulations will be mandatory.
Bladder cancer is a heterogeneous disease that is not depicted by current classification systems. It was originally classified into non-muscle invasive and muscle invasive. However, clinically and genetically variable tumors are summarized within both classes. A definition of three groups may better account for the divergence in prognosis and probably also choice of treatment. The first group represents mostly non-invasive tumors that reoccur but do not progress. Contrarily, the second group represent non-muscle invasive tumors that likely progress to the third group, the muscle invasive tumors. High throughput tumor profiling improved our understanding of the biology of bladder cancer. It allows the identification of molecular subtypes, at least three for non-muscle invasive bladder cancer (Class I, Class II and Class III) and six for muscle-invasive bladder cancer (luminal papillary, luminal non-specified, luminal unstable, stroma-rich, basal/squamous and neuroendocrine-like) with distinct clinical and molecular phenotypes. Molecular subtypes can be potentially used to predict the response to treatment (e.g., neoadjuvant chemotherapy and immune checkpoint inhibitors). Moreover, they may allow to characterize the evolution of bladder cancer through different pathways. However, to move towards precision medicine, the understanding of the biological meaning of these molecular subtypes and differences in the composition of cell subpopulations will be mandatory.Bladder cancer is a heterogeneous disease that is not depicted by current classification systems. It was originally classified into non-muscle invasive and muscle invasive. However, clinically and genetically variable tumors are summarized within both classes. A definition of three groups may better account for the divergence in prognosis and probably also choice of treatment. The first group represents mostly non-invasive tumors that reoccur but do not progress. Contrarily, the second group represent non-muscle invasive tumors that likely progress to the third group, the muscle invasive tumors. High throughput tumor profiling improved our understanding of the biology of bladder cancer. It allows the identification of molecular subtypes, at least three for non-muscle invasive bladder cancer (Class I, Class II and Class III) and six for muscle-invasive bladder cancer (luminal papillary, luminal non-specified, luminal unstable, stroma-rich, basal/squamous and neuroendocrine-like) with distinct clinical and molecular phenotypes. Molecular subtypes can be potentially used to predict the response to treatment (e.g., neoadjuvant chemotherapy and immune checkpoint inhibitors). Moreover, they may allow to characterize the evolution of bladder cancer through different pathways. However, to move towards precision medicine, the understanding of the biological meaning of these molecular subtypes and differences in the composition of cell subpopulations will be mandatory.
Author Minoli, Martina
Seiler, Roland
Kiener, Mirjam
Thalmann, George N.
Kruithof-de Julio, Marianna
AuthorAffiliation 2 Department of Urology, Inselspital, Bern University Hospital, 3008 Bern, Switzerland
1 Department of BioMedical Research, Urology Research Laboratory, University of Bern, 3008 Bern, Switzerland; martina.minoli@dbmr.unibe.ch (M.M.); mirjam.kiener@dbmr.unibe.ch (M.K.); George.Thalmann@insel.ch (G.N.T.); marianna.kruithofdejulio@dbmr.unibe.ch (M.K.-d.J.)
AuthorAffiliation_xml – name: 1 Department of BioMedical Research, Urology Research Laboratory, University of Bern, 3008 Bern, Switzerland; martina.minoli@dbmr.unibe.ch (M.M.); mirjam.kiener@dbmr.unibe.ch (M.K.); George.Thalmann@insel.ch (G.N.T.); marianna.kruithofdejulio@dbmr.unibe.ch (M.K.-d.J.)
– name: 2 Department of Urology, Inselspital, Bern University Hospital, 3008 Bern, Switzerland
Author_xml – sequence: 1
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  surname: Minoli
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  surname: Thalmann
  fullname: Thalmann, George N.
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  givenname: Marianna
  orcidid: 0000-0002-6085-7706
  surname: Kruithof-de Julio
  fullname: Kruithof-de Julio, Marianna
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  orcidid: 0000-0002-3529-2088
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  fullname: Seiler, Roland
BackLink https://www.ncbi.nlm.nih.gov/pubmed/32784716$$D View this record in MEDLINE/PubMed
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Issue 16
Keywords molecular subtypes
non-muscle invasive
targeted therapy
bladder cancer
muscle invasive
evolution
classification
Language English
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PublicationDate 20200807
PublicationDateYYYYMMDD 2020-08-07
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  year: 2020
  text: 20200807
  day: 7
PublicationDecade 2020
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PublicationTitle International journal of molecular sciences
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Publisher MDPI AG
MDPI
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Snippet Bladder cancer is a heterogeneous disease that is not depicted by current classification systems. It was originally classified into non-muscle invasive and...
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SubjectTerms Animals
Biomarkers
Biomarkers, Tumor - genetics
Bladder cancer
Cancer therapies
Chemotherapy
FDA approval
Humans
Medical prognosis
Metastasis
Muscles - pathology
Review
Surveillance
Treatment Failure
Tumors
Urinary Bladder Neoplasms - classification
Urinary Bladder Neoplasms - genetics
Urinary Bladder Neoplasms - therapy
Urothelium - pathology
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Title Evolution of Urothelial Bladder Cancer in the Context of Molecular Classifications
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