Pharmacogenomics in bladder cancer

• Published in: Urologic oncology 2014, Vol.32 (1), p.16-22
• Main Authors: Dancik, Garrett M., Ph.D, Theodorescu, Dan, M.D., Ph.D
• Format: Article
• Language: English
• Subjects: Antineoplastic Agents - pharmacology; ATP Binding Cassette Transporter, Sub-Family B - metabolism; Biomarkers, Tumor - metabolism; BRCA1 Protein - metabolism; Cisplatin - pharmacology; DNA-Binding Proteins - metabolism; Endonucleases - metabolism; Humans; Neoadjuvant Therapy; Pharmacogenetics - methods; Prospective Studies; Tumor Suppressor Protein p53 - metabolism; Urinary Bladder Neoplasms - drug therapy; Urinary Bladder Neoplasms - genetics; Urology
• ISSN: 1078-1439; 1873-2496
• DOI: 10.1016/j.urolonc.2013.09.007

Abstract Bladder cancer is a common cancer worldwide. For patients presenting with muscle-invasive disease, the 5-year survival rate is approximately 50%. Cisplatin-based combination chemotherapy is recommended in the neoadjuvant setting before cystectomy and is also the first line in the metastatic setting. However, the survival benefit of such therapy is modest. The identification of pharmacogenomic biomarkers would enable the rational and personalized treatment of patients by selecting those patients that would benefit most from such therapies sparing others the unnecessary toxicity. Conventional therapies would be recommended for an expected responder, whereas a nonresponder would be considered for alternative therapies selected on the basis of the individual's molecular profile. Although few effective bladder cancer therapies have been introduced in the past 30 years, several targeted therapies against the molecular drivers of bladder cancer appear promising. This review summarizes pharmacogenomic biomarkers that require further investigation or prospective evaluation or both, and publicly available tools for drug discovery and biomarker identification from in vitro data.