Molecular markers in bladder cancer

Francesco Soria, Laura-Maria Krabbe, Tilman Todenhöfer, Jakub Dobruch, Anirban P Mitra, Brant A Inman, Kilian M Gust, Yair Lotan, Shahrokh F Shariat, Francesco Soria, Laura-Maria Krabbe, Tilman Todenhöfer, Jakub Dobruch, Anirban P Mitra, Brant A Inman, Kilian M Gust, Yair Lotan, Shahrokh F Shariat

Abstract

Purpose: Use of molecular markers in urine, tissue or blood offers potential opportunities to improve understanding of bladder cancer biology which may help identify disease earlier, risk stratify patients, improve prediction of outcomes or help target therapy.

Methods: A review of the published literature was performed, without restriction of time.

Results: Despite the fast-growing literature about the topic and the approval of several urinary biomarkers for use in clinical practice, they have not reached the level of evidence for widespread utilization. Biomarkers could be used in different clinical scenarios, mainly to overcome the limitations of current diagnostic, predictive, and prognostic tools. They have been evaluated to detect bladder cancer in asymptomatic populations or those with hematuria and in surveillance of disease as adjuncts to cystoscopy. There is also a potential role as prognosticators of disease recurrence, progression and survival both in patients with non-invasive cancers and in those with advanced disease. Finally, they promise to be helpful in predicting the response to local and/or systemic chemotherapy and/or immunotherapy.

Conclusions: To date, due to the lack of high-quality prospective trials, the level of evidence provided by the current literature remains low and, therefore, the potential of biomarkers exceeds utilization in clinical practice.

Keywords: Bladder cancer; Blood biomarkers; Guidelines; Tissue biomarkers; Urinary biomarkers.

Conflict of interest statement

Conflict of interest

I certify that all conflicts of interest, including specific financial interests and relationships and affiliations relevant to the subject matter or materials discussed in the manuscript are the following: Shahrokh Shariat owns or co-owns the following patents: methods to determine prognosis after therapy for prostate cancer, granted 2002-09-06; methods to determine prognosis after therapy for bladder cancer, granted 2003-06-19; prognostic methods for patients with prostatic disease, granted 2004-08-05; soluble Fas: urinary marker for the detection of bladder transitional cell carcinoma, granted 2010-07-20. He is an advisory board member of Astellas, Cepheid, Ipsen, Jansen, Lilly, Olympus, Pfizer, Pierre Fabre, Sanofi, and Wolff. He is a speaker for Astellas, Ipsen, Jansen, Lilly, Olympus, Pfizer, Pierre Fabre, Sanochemia, Sanofi and Wolff.

Ethical standards

This study was conducted according to the Declaration of Helsinki.

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