Recent studies demonstrated that bladder cancers can be grouped into basal and luminal molecular subtypes that possess distinct biological and clinical characteristics.Basal bladder cancers express biomarkers characte...Recent studies demonstrated that bladder cancers can be grouped into basal and luminal molecular subtypes that possess distinct biological and clinical characteristics.Basal bladder cancers express biomarkers characteristic of cancer stem cells and epithelial-tomesenchymal transition(EMT).Patients with basal cancers tend have more advanced stage and metastatic disease at presentation.In preclinical models basal human orthotopic xenografts are also more metastatic than luminal xenografts are,and they metastasize via an EMT-dependent mechanism.However,preclinical and clinical data suggest that basal cancers are also more sensitive to neoadjuvant chemotherapy(NAC),such that most patients with basal cancers who are aggressively managed with NAC have excellent outcomes.Importantly,luminal bladder cancers can also progress to become invasive and metastatic,but they appear to do so via mechanisms that are much less dependent on EMT and may involve help from stromal cells,particularly cancer-associated fibroblasts(CAFs).Although patients with luminal cancers do not appear to derive much clinical benefit from NAC,the luminal tumors that are infiltrated with stromal cells appear to be sensitive to anti-PDL1 antibodies and possibly other immune checkpoint inhibitors.Therefore,neoadjuvant and/or adjuvant immunotherapy may be the most effective approach in treating patients with advanced or metastatic infiltrated luminal bladder cancers.展开更多
From the early roots of modern urology to today,genitourinary(GU)cancers have been an important part of the fields of urology and cancer biology.As medical science has advanced,newer clinical and basic viewpoints have...From the early roots of modern urology to today,genitourinary(GU)cancers have been an important part of the fields of urology and cancer biology.As medical science has advanced,newer clinical and basic viewpoints have impacted the thinking and practice in this important field.As such,GU oncology has been consistently seen as an area of rapid evolution both in biological understanding and clinical care.GU cancers continue to rise in incidence worldwide.Moreover,they represent a significant portion of cancer mortality in Asia and the western world.These facts have been met with some of the boldest and most important advances in cancer biology and therapy that have reshaped this field.展开更多
文摘Recent studies demonstrated that bladder cancers can be grouped into basal and luminal molecular subtypes that possess distinct biological and clinical characteristics.Basal bladder cancers express biomarkers characteristic of cancer stem cells and epithelial-tomesenchymal transition(EMT).Patients with basal cancers tend have more advanced stage and metastatic disease at presentation.In preclinical models basal human orthotopic xenografts are also more metastatic than luminal xenografts are,and they metastasize via an EMT-dependent mechanism.However,preclinical and clinical data suggest that basal cancers are also more sensitive to neoadjuvant chemotherapy(NAC),such that most patients with basal cancers who are aggressively managed with NAC have excellent outcomes.Importantly,luminal bladder cancers can also progress to become invasive and metastatic,but they appear to do so via mechanisms that are much less dependent on EMT and may involve help from stromal cells,particularly cancer-associated fibroblasts(CAFs).Although patients with luminal cancers do not appear to derive much clinical benefit from NAC,the luminal tumors that are infiltrated with stromal cells appear to be sensitive to anti-PDL1 antibodies and possibly other immune checkpoint inhibitors.Therefore,neoadjuvant and/or adjuvant immunotherapy may be the most effective approach in treating patients with advanced or metastatic infiltrated luminal bladder cancers.
文摘From the early roots of modern urology to today,genitourinary(GU)cancers have been an important part of the fields of urology and cancer biology.As medical science has advanced,newer clinical and basic viewpoints have impacted the thinking and practice in this important field.As such,GU oncology has been consistently seen as an area of rapid evolution both in biological understanding and clinical care.GU cancers continue to rise in incidence worldwide.Moreover,they represent a significant portion of cancer mortality in Asia and the western world.These facts have been met with some of the boldest and most important advances in cancer biology and therapy that have reshaped this field.
