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Molecular and histopathology directed therapy for advanced bladder cancer

机译:用于晚期膀胱癌的分子和组织病理学治疗

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tBladder cancer is a heterogeneous group of tumours with at least 40 histological subgroups. Patients with localized disease can be cured with surgical resection or radiotherapy, but such curative options are limited in the setting of recurrent disease or distant spread, in which case systemic therapy is used to control disease and palliate symptoms. Cytotoxic chemotherapy has been the mainstay of treatment for advanced bladder cancer, but high-quality evidence is lacking to inform the management of rare subgroups that are often excluded from studies. Advances in molecular pathology, the development of targeted therapies and the resurgence of immunotherapy have led to the reclassification of bladder cancer subgroups and rigorous efforts to define predictive biomarkers for cancer therapies. In this Review, we present the current evidence for the management of conventional, variant and divergent urothelial cancer subtypes, as well as non-urothelial bladder cancers, and discuss how the integration of genomic, transcriptomic and proteomic characterization of bladder cancer could guide future therapies.
机译:细胞膜癌是一种具有至少40个组织学亚组的异质肿瘤组。局部疾病的患者可以用外科切除或放射治疗治愈,但这种疗效在复发性疾病或远处蔓延的环境中受到限制,在这种情况下,用于控制疾病和显着症状。细胞毒性化学疗法一直是治疗晚期膀胱癌的主干,但缺乏高质量的证据,以告知经常被排除在研究中的稀有亚组的管理。分子病理学的进步,靶向疗法的发展和免疫疗法的复苏导致膀胱癌亚群的重新分类和严格努力来定义癌症疗法的预测生物标志物。在这篇综述中,我们介绍了常规,变异和发散的尿路上下管癌亚型的现有证据,以及非尿路上膀胱癌,并讨论了膀胱癌的基因组,转录组和蛋白质组表征的结合如何引导未来的疗法。

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