Noninvasive approaches for detecting and monitoring bladder cancer

Abstract

Bladder cancer is the second most common cancer of the urinary tract. Despite existing multiapproach treatment strategies, including radical cystectomy, bladder-sparing therapy with transurethral resection, chemotherapy and radiotherapy, patients with deeply invasive bladder cancers display poor prognosis, with a survival rate of only 30–50%. This can be avoided through proper surveillance and monitoring. Several genetic factors contribute to the progression of bladder cancer, and these molecules serve as cancer biomarkers. Blood, plasma, serum and urine are commonly analyzed for the presence of biomarkers, which can be both nuclear as well as mitochondrial in nature. This review discusses the efficacy of such biomarkers as well as highlights some potential prognostic markers in the field of noninvasive bladder cancer detection.

Keywords:

• biomarker
• bladder cancer
• noninvasive detection

Acknowledgements

The authors wish to acknowledge the support of the National Institutes of Health, National Cancer Institute through the grants R01 CA097318 (PB Fisher), R01 CA127641 (PB Fisher), R01 CA134721 (PB Fisher), R01 CA138540 (D Sarkar) and P01 CA104177 (PB Fisher); the Department of Defense (DOD) Prostate Cancer Research Program (PCRP) of the Office of the Congressionally Directed Medical Research Programs (CDMRP) W81XWH-10-PCRP-SIDA (PB Fisher and Xiang-Yang Wang); an A. David Mazzone Challenge Award from the Prostate Cancer Foundation (MA Pomper, PB Fisher, G Sgouros); the James S. McDonnell Foundation; the National Foundation for Cancer Research (PB Fisher); the Thelma Newmeyer Corman Chair in Cancer Research (PB Fisher); the Harrison Scholar program (D Sarkar); and the VCU Massey Cancer Center (PB Fisher, D Sarkar). We thank S Dasgupta for advice relative to this review.

Financial & competing interests disclosure

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Key issues

• Despite existing multiapproach treatment strategies, patients with deeply invasive bladder cancers display poor prognosis, with a survival rate of only 30–50%.

• Frequent monitoring is essential for detecting bladder cancer progression.

• Several molecular markers have been scrutinized for bladder cancer surveillance; however, many of these markers generate false positives and display sensitivity and specificity issues.

• Noninvasive detection relies on molecular marker molecules present in blood, serum, plasma, and/or urine. These markers need to be thoroughly vetted to develop improved high-throughput multiple biomarker-based detection systems to identify bladder cancer with high sensitivity and specificity.