title: New and promising strategies in the management of bladder cancer.
abstract: Bladder cancer is a complex and aggressive disease for which treatment strategies have had limited success. Improvements in detection, treatment, and outcomes in bladder cancer will require the integration of multiple new approaches, including genomic profiling, immunotherapeutics, and large randomized clinical trials. New and promising strategies are being tested in all disease states, including nonmuscle-invasive bladder cancer (NMIBC), muscle-invasive bladder cancer (MIBC), and metastatic urothelial carcinoma (UC). Efforts are underway to develop better noninvasive urine biomarkers for use in primary or secondary detection of NMIBC, exploiting our genomic knowledge of mutations in genes such as RAS, FGFR3, PIK3CA, and TP53 and methylation pathways alone or in combination. Recent data from a large, randomized phase III trial of adjuvant cisplatin-based chemotherapy add to our knowledge of the value of perioperative chemotherapy in patients with MIBC. Finally, bladder cancer is one of a growing list of tumor types that respond to immune checkpoint inhibition, opening the potential for new therapeutic strategies for treatment of this complex and aggressive disease.
authors.affiliation: From the Genitourinary Malignancies Branch, Center for Cancer Research, National Cancer Institute at the National Institutes of Health, Bethesda, MD; US Oncology Research, Houston, TX and Comprehensive Cancer Centers of Nevada, Las Vegas, NV; University of Colorado Cancer Center, Denver, CO.
authors.forename: Andrea B
authors.initials: AB
authors.lastname: Apolo
authors.affiliation: From the Genitourinary Malignancies Branch, Center for Cancer Research, National Cancer Institute at the National Institutes of Health, Bethesda, MD; US Oncology Research, Houston, TX and Comprehensive Cancer Centers of Nevada, Las Vegas, NV; University of Colorado Cancer Center, Denver, CO.
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Vogelzang
authors.affiliation: From the Genitourinary Malignancies Branch, Center for Cancer Research, National Cancer Institute at the National Institutes of Health, Bethesda, MD; US Oncology Research, Houston, TX and Comprehensive Cancer Centers of Nevada, Las Vegas, NV; University of Colorado Cancer Center, Denver, CO.
authors.forename: Dan
authors.initials: D
authors.lastname: Theodorescu
mesh_terms: D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D006801:Humans; D009154:Mutation; D020360:Neoadjuvant Therapy; D061026:Programmed Cell Death 1 Receptor / Q000037:antagonists & inhibitors; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology
chemical_list: D000911:Antibodies, Monoclonal; D000970:Antineoplastic Agents; C105992:PDCD1 protein, human; D061026:Programmed Cell Death 1 Receptor