Bladder cancer: what’s new in 2017

Treatment of bladder cancer has been a complicated problem. Low survival for regional and metastatic disease remains. In recent years,  the efforts of doctors, biologists, diagnosticians were aimed at development of new technologies in these spheres and improvement of treatment results for this pathology. In this review, current views on diagnosis, the role of repeated surgical interventions in non-muscle-invasive bladder cancer, etc. are presented. Advances in molecular biology allowed to differentiate subtypes of urothelial bladder cancer. Importantly, the results of biomolecular studies allowed to identify different responses to drug treatment. Moreover, in some cases these results have a follow-up period of up to 3 years. Based on other data characterizing the tumor, the effectiveness of new drugs for treatment of regional, metastatic and post-cisplatin therapy bladder cancer was evaluated. These results allow to hope for increased life span and quality of life for patients with this severe disease.

1. European Association of Urology. Guidelines 2017 edn. Guidelines on non-muscle-invasive bladder cancer. Pp. 11, 13, 15, 16, 39.

2. Miyamoto D.T., Drumm M., Clayman R.H. et al. Outcomes and tolerability of selective bladder preservation by combined modality therapy for invasive bladder cancer in elderly patients. ASCO 2017. Abstract 316. DOI: 10.1200/JCO.2017.35.6_suppl.316.

3. Nahar B., Koru-Sengul T., Miao F. et al. Comparison of readmission and shortterm mortality rates between different types of urinary diversion in patients undergoing radical cystectomy. World J Urol 2018;36(3):393–9. DOI: 10.1007/s00345017-2140-3. PMID: 29230495.

4. Bellmunt J., Kerst J.M., Vázquez F. et al. A randomized phase II/III study of cabazitaxel versus vinflunine in metastatic or locally advanced transitional cell carcinoma of the urothelium (SECAVIN). Ann Oncol 2017;28(7):1517–22. DOI: 10.1093/annonc/mdx186. PMID: 28419193.

5. European Association of Urology. Guidelines 2017 edn. Guidelines on muscle-invasive and metastatic bladder cancer. P. 39.

6. Inman B.A., Sebo T.J., Frigola X. et al. PD-L1 (B7-H1) expression by urothelial carcinoma of the bladder and BCG-induced granulomata: associations with localized stage progression. Cancer 2007;109(8):1499–505. DOI: 10.1002/cncr.22588. PMID: 17340590.

7. Bajorin D.F., De Wit R., Vaughn D.J. et al. Planned survival analysis from KEYNOTE-045: phase 3, open-label study of pembrolizumab (pembro) versus paclitaxel, docetaxel, or vinflunine in recurrent, advanced urothelial cancer (UC). ASCO 2017. Abstract 4501. DOI: 10.1200/JCO.2017.35.15_suppl.4501.

8. Chi L.J., Lu H.T., Li G.L. et al. Involvement of T helper type 17 and regulatory T cell activity in tumour immunology of bladder carcinoma. Clin Exp Immunol 2010;161(3):480–9. DOI: 10.1111/j.1365-2249.2010.04215.x. PMID: 20646003.

9. Mellman I., Coukos G., Dranoff G. Cancer immunotherapy comes of age. Nature 2011;480(7378):480–9. DOI: 10.1038/nature10673. PMID: 22193102.

10. Horn T., Laus J., Seitz A.K. et al. The prognostic effect of tumour-infiltrating lymphocytic subpopulations in bladdercancer. World J Urol 2016;34(2):181–7. DOI: 10.1007/s00345-015-1615-3. PMID: 26055646.

11. Lang F., Linlin M., Ye T., Yuhai Z. Alterations of dendritic cell subsets and TH1/ TH2 cytokines in the peripheral circulation of patients with superficial transitional cell carcinoma of the bladder. J Clin Lab Anal 2012;26(5):365–71. DOI: 10.1002/jcla.21532. PMID: 23001982.

12. Chopin D., Barei-Moniri R., Maille P. et al. Human urinary bladder transitional cell carcinomas acquire the functional Fas ligand during tumor progression. Am J Pathol 2003;162(4):1139–49. DOI: 10.1016/S0002-9440(10)63910-7. PMID: 12651606.

13. Ackerman С., Mariathasan S., Nickles D. et al. Molecular subtyping of metastatic urothelial bladder cancer. ASCO 2017. Abstract 326. DOI: 10.1200/JCO.2017.35.6_ suppl.326.

14. Seiler R., Ashab H.A.D., Erho N. et al. Muscle invasive bladder cancer: a single sample patient assay to predict molecular subtypes and benefit of neoadjuvant chemotherapy. Eur Urol 2017;16(3); e1567. DOI: 10.1016/S15699056(17)30952-1.

15. Efstathiou J.A., Gibb E., Miyamoto D.T. et al. Subtyping muscle-invasive bladder cancer to assess clinical response to trimodality therapy. ASCO 2017. Abstract 287. DOI: abs/10.1200/JCO.2017.35.6_ suppl.287.

16. Balar A.V., Castellano D., O’Donnell P.H. et al. First-line pembrolizumab in cisplatin-ineligible patients with locally advanced and unresectable or metastatic urothelial cancer (KEYNOTE-052): a multicentre, single-arm, phase 2 study. Lancet Oncol 2017;18(11):1483–92. DOI: 10.1016/S1470-2045(17)30616-2. PMID: 28967485.

17. Balar A.V., Galsky M.D., Rosenberg J.E. et al. Atezolizumab as first-line treatment in cisplatin-ineligible patients with locally advanced and metastatic urothelial carcinoma: a single-arm, multicentre, phase 2 trial. Lancet 2017;389(10064):67–76. DOI: 10.1016/S0140-6736(16)32455-2. PMID: 27939400.

18. Bellmunt J., Balar A., Galsky M.D. et al. IMvigor210: update analyses of first-line (1L) atezolizumab (atezo) in cisplatin (cis)-ineligible locally advanced/metastatic urothelial carcinoma. ESMO 2016. Abstract 782PD. DOI: 10.1200/JCO.2016.34.15_suppl.LBA45.

19. Sharma P., Retz M., Siefker-Radtke A. et al. Nivolumab in metastatic urothelial carcinoma after platinum therapy (CheckMate 275): a multicentre, single-arm, phase 2 trial. Lancet Oncol 2017;18(3):312–22. DOI: 10.1016/S14702045(17)30065-7. PMID: 28131785.