Open AccessTreatment of muscle‐invasive and advanced bladder cancer in 2020
Author(s) -
Patel Vaibhav G.,
Oh William K.,
Galsky Matthew D.
Publication year - 2020
Publication title -
ca: a cancer journal for clinicians
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 62.937
H-Index - 168
eISSN - 1542-4863
pISSN - 0007-9235
DOI - 10.3322/caac.21631
Subject(s) - bladder cancer , medicine , cancer , drug development , immunotherapy , oncology , cancer research , bioinformatics , drug , pharmacology , biology
Bladder cancer accounts for nearly 170,000 deaths worldwide annually. For over 4 decades, the systemic management of muscle‐invasive and advanced bladder cancer has primarily consisted of platinum‐based chemotherapy. Over the past 10 years, innovations in sequencing technologies have led to rapid genomic characterization of bladder cancer, deepening our understanding of bladder cancer pathogenesis and exposing potential therapeutic vulnerabilities. On the basis of its high mutational burden, immune checkpoint inhibitors were investigated in advanced bladder cancer, revealing durable responses in a subset of patients. These agents are now approved for several indications and highlight the changing treatment landscape of advanced bladder cancer. In addition, commonly expressed molecular targets were leveraged to develop targeted therapies, such as fibroblast growth factor receptor inhibitors and antibody‐drug conjugates. The molecular characterization of bladder cancer and the development of novel therapies also have stimulated investigations into optimizing treatment approaches for muscle‐invasive bladder cancer. Herein, the authors review the history of muscle‐invasive and advanced bladder cancer management, highlight the important molecular characteristics of bladder cancer, describe the major advances in treatment, and offer future directions for therapeutic development.