Emerging targeted therapies for bladder cancer: a disease waiting for a drug.
Urothelial cell carcinoma is the fifth most common cancer and the costliest to treat. This is largely because of all new cases, about 70% present as superficial disease and this while rarely fatal, tends to recur, requiring long-term follow-up and repeat interventions. The standard of care, intravesical chemo- and immunotherapy, while effective, is associated with a considerable side-effect profile and approximately 30% of patients either fail to respond to treatment or suffer recurrent disease within 5 years. Muscle-invasive bladder cancer is life threatening, showing modest chemosensitivity, and usually requires radical cystectomy. Although bladder cancer is fairly well-genetically characterized, clinical trials with molecularly targeted agents have, in comparison to other solid tumors such as lung, breast and prostate, been few in number and largely unsuccessful, with no new agents being registered in the last 20 years. Hence, bladder cancer represents a considerable opportunity and challenge for molecularly targeted therapy.
Dovedi
Simon J
SJ
Cancer and Infection Research Area, AstraZeneca, Mereside, Alderley Park, Macclesfield, Cheshire SK10 4TG, UK.
Davies
Barry R
BR
D000283:Administration, Intravesical; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000191:economics / Q000494:pharmacology* / Q000627:therapeutic use; D001500:BCG Vaccine / Q000008:administration & dosage / Q000627:therapeutic use; D002278:Carcinoma in Situ / Q000188:drug therapy / Q000191:economics / Q000453:epidemiology / Q000276:immunology / Q000601:surgery; D002291:Carcinoma, Papillary / Q000188:drug therapy / Q000191:economics / Q000453:epidemiology / Q000276:immunology / Q000601:surgery; D002295:Carcinoma, Transitional Cell / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology / Q000276:immunology / Q000532:radiotherapy / Q000601:surgery; D002453:Cell Cycle / Q000187:drug effects; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D052246:Cyclooxygenase 2 Inhibitors / Q000627:therapeutic use; D015653:Cystectomy; D019468:Disease Management; D016503:Drug Delivery Systems; D015507:Drugs, Investigational / Q000627:therapeutic use*; D015316:Genetic Therapy; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins; D009361:Neoplasm Invasiveness; D009363:Neoplasm Proteins / Q000037:antagonists & inhibitors / Q000502:physiology; D009389:Neovascularization, Pathologic / Q000188:drug therapy; D015398:Signal Transduction / Q000187:drug effects; D016159:Tumor Suppressor Protein p53 / Q000037:antagonists & inhibitors; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology / Q000276:immunology / Q000532:radiotherapy / Q000601:surgery
D020533:Angiogenesis Inhibitors; D000970:Antineoplastic Agents; D001500:BCG Vaccine; D052246:Cyclooxygenase 2 Inhibitors; D015507:Drugs, Investigational; D036341:Intercellular Signaling Peptides and Proteins; D009363:Neoplasm Proteins; D016159:Tumor Suppressor Protein p53