Bladder cancer

Nature Reviews Disease Primers, Journal Year: 2023, Volume and Issue: 9(1)

Published: Oct. 26, 2023

Language: Английский

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Liquid Biopsy Biomarkers in Urine: A Route towards Molecular Diagnosis and Personalized Medicine of Bladder Cancer

Journal of Personalized Medicine, Journal Year: 2021, Volume and Issue: 11(3), P. 237 - 237

Published: March 23, 2021

Bladder cancer (BC) is characterized by high incidence and recurrence rates together with genomic instability elevated mutation degree. Currently, cystoscopy combined cytology routinely used for diagnosis, prognosis disease surveillance. Such an approach often associated several side effects, discomfort the patient economic burden. Thus, there essential demand of non-invasive, sensitive, fast inexpensive biomarkers clinical management BC patients. In this context, liquid biopsy represents a very promising tool that has been widely investigated over last decade. Liquid will likely be at basis selection precision medicine, both in terms treatment choice real-time monitoring therapeutic effects. Several different urinary have proposed BC, including DNA methylation mutations, protein-based assays, non-coding RNAs mRNA signatures. review, we summarized state art on available tests concerning their potential applications detection, prognosis, surveillance response to therapy.

Language: Английский

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Cancer Immunotherapies: From Efficacy to Resistance Mechanisms – Not Only Checkpoint Matters

Frontiers in Immunology, Journal Year: 2021, Volume and Issue: 12

Published: July 21, 2021

The immunotherapeutic treatment of various cancers with an increasing number immune checkpoint inhibitors (ICIs) has profoundly improved the clinical management advanced diseases. However, just a fraction patients clinically responds to and benefits from mentioned therapies; large proportion do not respond or quickly become resistant, hyper- pseudoprogression occur in certain patient populations. Furthermore, no effective predictive factors have been clearly screened defined. In this review, we discuss underlying elucidation potential resistance mechanisms identification for responses. Considering heterogeneity tumours complex microenvironment (composition cell subtypes, disease processes, lines treatment), expression levels may be only immunotherapy difficulty resistance. Researchers should consider tumour (TME) landscape greater depth aspect cells but also histology, molecular subtype, clonal evolution as well micro-changes fine structural features area, such myeloid polarization, fibroblast clusters tertiary lymphoid structure formation. A comprehensive analysis profiles lesions is needed determine value on responses, precision medicine more important.

Language: Английский

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Non–muscle-invasive bladder cancer molecular subtypes predict differential response to intravesical Bacillus Calmette-Guérin

Science Translational Medicine, Journal Year: 2023, Volume and Issue: 15(697)

Published: May 24, 2023

The recommended treatment for patients with high-risk non-muscle-invasive bladder cancer (HR-NMIBC) is tumor resection followed by adjuvant Bacillus Calmette-Guérin (BCG) instillations. However, only 50% of benefit from this therapy. If progression to advanced disease occurs, then must undergo a radical cystectomy risks substantial morbidity and poor clinical outcome. Identifying tumors unlikely respond BCG can translate into alternative treatments, such as early cystectomy, targeted therapies, or immunotherapies. Here, we conducted molecular profiling 132 BCG-naive HR-NMIBC 44 recurrences after (34 matched), which uncovered three distinct response subtypes (BRS1, 2 BRS3). Patients BRS3 had reduced recurrence-free progression-free survival compared BRS1/2. expressed high epithelial-to-mesenchymal transition basal markers an immunosuppressive profile, was confirmed spatial proteomics. Tumors that recurred were enriched BRS3. BRS stratification validated in second cohort 151 HR-NMIBC, the outperformed guideline-recommended risk based on clinicopathological variables. For application, commercially approved assay able predict area under curve 0.87. These will allow improved identification at highest have potential be used select more appropriate treatments BCG.

Language: Английский

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Integrating Multi-Omics Data With EHR for Precision Medicine Using Advanced Artificial Intelligence

IEEE Reviews in Biomedical Engineering, Journal Year: 2023, Volume and Issue: 17, P. 80 - 97

Published: Oct. 12, 2023

With the recent advancement of novel biomedical technologies such as high-throughput sequencing and wearable devices, multi-modal data ranging from multi-omics molecular to real-time continuous bio-signals are generated at an unprecedented speed scale every day. For first time, these able make precision medicine close a reality. However, due volume complexity, making good use requires major effort. Researchers clinicians actively developing artificial intelligence (AI) approaches for data-driven knowledge discovery causal inference using variety modalities. These AI-based have demonstrated promising results in various healthcare applications. In this review paper, we summarize state-of-the-art AI models integrating electronic health records (EHRs) medicine. We discuss challenges opportunities with EHRs future directions. hope can inspire research

Language: Английский

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Clinical and Genomic Landscape of FGFR3-Altered Urothelial Carcinoma and Treatment Outcomes with Erdafitinib: A Real-World Experience

Clinical Cancer Research, Journal Year: 2023, Volume and Issue: 29(22), P. 4586 - 4595

Published: Sept. 8, 2023

Abstract Purpose: Erdafitinib is the only FDA-approved targeted therapy for FGFR2/3-altered metastatic urothelial cancer. We characterized genetic landscape of FGFR-altered carcinoma and real-world clinical outcomes with erdafitinib, including on-treatment genomic evolution. Experimental Design: Prospectively collected data were integrated institutional to define carcinoma. To identify mechanisms erdafitinib resistance, a subset patients underwent prospective cell-free (cf) DNA assessment. Results: FGFR3 alterations predictive sensitivity identified in 39% (199/504) non-muscle invasive, 14% (75/526) muscle-invasive, 43% (81/187) localized upper tract, 26% (59/228) specimens. One patient had potentially sensitizing FGFR2 fusion. Among 27 FGFR3-altered cases primary tumor metachronous metastasis, 7 paired specimens (26%) displayed discordant status. achieved response rate 40% but median progression-free overall survival 2.8 6.6 months, respectively (n = 32). Dose reductions (38%, 12/32) interruptions (50%, 16/32) common. Putative resistance mutations detected cfDNA involved TP53 5), AKT1 1), second-site 2). Conclusions: are common carcinoma, whereas rare. Discordance mutational status between tumors occurs frequently raises concern over sequencing archival guide selection therapy. responses typically brief dosing was limited by toxicity. FGFR3, AKT1, represent putative acquired resistance.

Language: Английский

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Precision Medicine in Bladder Cancer: Present Challenges and Future Directions

Journal of Personalized Medicine, Journal Year: 2023, Volume and Issue: 13(5), P. 756 - 756

Published: April 28, 2023

Bladder cancer (BC) is characterized by significant histopathologic and molecular heterogeneity. The discovery of pathways knowledge cellular mechanisms have grown exponentially may allow for better disease classification, prognostication, development novel more efficacious noninvasive detection surveillance strategies, as well selection therapeutic targets, which can be used in BC, particularly a neoadjuvant or adjuvant setting. This article outlines recent advances the pathology BC with understanding deeper focus on deployment promising biomarkers avenues that soon make transition into domain precision medicine clinical management patients BC.

Language: Английский

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Health-related Quality of Life in Patients with Previously Treated Advanced Urothelial Carcinoma from EV-301: A Phase 3 Trial of Enfortumab Vedotin Versus Chemotherapy

European Urology, Journal Year: 2024, Volume and Issue: 85(6), P. 574 - 585

Published: Feb. 28, 2024

In comparison to chemotherapy, enfortumab vedotin (EV) prolonged overall survival in patients with previously treated advanced urothelial carcinoma EV-301. The objective of the present study was assess patient experiences EV versus chemotherapy using patient-reported outcome (PRO) analysis health-related quality life (HRQoL). For phase 3 EV-301 trial randomized or we assessed responses validated European Organisation for Research and Treatment Cancer Quality Life Questionnaire Core 30 (QLQ-C30) at baseline, weekly first 12 wk, then every wk until discontinuation. We analyzed QLQ-C30 change from baseline week 12, confirmed improvement rate, time deterioration. Baseline PRO compliance rates were 91% arm (n = 301) 89% 307); corresponding average 70% 67%. Patients receiving had reduced pain (difference 12: −5.7, 95% confidence interval [CI] −10.8 −0.7; p 0.027) worsening appetite loss (7.3, CI 0.90–13.69; 0.026). Larger proportions reported HRQoL than arm; odds a across ten function/symptom scales 1.67 2.76 times higher chemotherapy. shorter global health status (GHS)/QoL, fatigue, pain, physical, role, emotional, social functioning (all < 0.05). delayed deterioration GHS/QoL (p 0.027), but occurred earlier 0.009) maintained, Better results some scales, greatest difference observed pain. These findings reinforce safety efficacy outcomes benefits cancer urinary tract drug maintained their is registered on ClinicalTrials.gov as NCT03474107 EudraCT 2017-003344-21.

Language: Английский

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One-dimensional nanosonosensitizer boosted multiple branches of immune responses against MHC-deficient immune-evasive urologic tumor

Science Advances, Journal Year: 2025, Volume and Issue: 11(5)

Published: Jan. 29, 2025

Cancer immunotherapies rely on CD8 + cytolytic T lymphocytes (CTLs) in recognition and eradication of tumor cells via antigens presented major histocompatibility complex class I (MHC-I) molecules. However, we observe MHC-I deficiency human murine urologic tumors, posing daunting challenges for successful immunotherapy. We herein report an unprecedented nanosonosensitizer one-dimensional bamboo-like multisegmented manganese dioxide@manganese–bismuth vanadate (BMMBV) to boost multiple branches immune responses targeting MHC-I–deficient tumors. BMMBV markedly augments sonodynamic activity contributed by heteroatoms the lattice bismuth with narrowing bandgaps. Under sonoirradiation, enhances antigen spreading emission adjuvant signals, which potentiate dendritic cell maturation, thereby eliciting high aptitude CTLs. This therapy substantially up-regulates MHC expression cells, are reversely sensitive Alongside, extensive innate complement CTLs eliminating mouse study offers a reinforced strategy against antigen-loss immune-evasive tumor.

Language: Английский

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Role of Exosomal miRNA in Bladder Cancer: A Promising Liquid Biopsy Biomarker

International Journal of Molecular Sciences, Journal Year: 2021, Volume and Issue: 22(4), P. 1713 - 1713

Published: Feb. 8, 2021

Bladder cancer (BCa) is the most prevalent neoplasia of urinary tract. Unfortunately, limited improvements in effective BCa management have meant that it remains a challenging disease. Cystoscopy has been gold standard for diagnosis and surveillance over two centuries but an invasive expensive approach. Recently, liquid biopsy identified as promising field research, due to its noninvasiveness ease sampling. Liquid samples could provide comprehensive information regarding genetic landscape track genomic evolution disease time. Exosomes, which contain RNAs, DNAs, proteins, are potential source tumor biomarkers samples. In particular, exosomal miRNAs (exomiRs) hold great promise development progression. this review, we overview biomarkers, with particular focus on use exomiRs cancer, summarize their clinical implications BCa. Finally, discuss future perspectives these research.

Language: Английский

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