Molekulare Charakterisierung des Urothelkarzinoms der Harnblase: Ist ein klinischer Nutzen in Sicht?

Zusammenfassung

Das Urothelkarzinom der Harnblase ist trotz multimodaler Therapie mit einer hohen Rezidiv- und krankheitsspezifischen Mortalitätsrate behaftet. Diese konnte während der letzten beiden Jahrzehnte nicht signifikant gesenkt werden. Die aktuelle histopathologische Klassifikation und klinische Risikostratifizierung ist ungenau. Daher könnte ein besseres Verständnis der Tumorbiologie von entscheidender Bedeutung für therapeutische Verbesserungen sein. Erkenntnisse über die Tumorbiologie können in molekulare Marker, die sowohl die Diagnostik als auch das Therapiemonitoring verbessern können, übersetzt werden. Es wurden bereits diverse mögliche Zielstrukturen auf molekularer Ebene identifiziert. Dazu gehören vielversprechende Zielstrukturen wie FGFR3 (Fibroblast growth factor receptor 3), HER2 (Human epidermal growth factor receptor 2) und PD1/PDL1 (Programmed cell death-1). Diese müssen in klinischen Studien validiert werden. Wir berichten über die Molekularbiologie des Urothelkarzinoms der Harnblase und zeigen daraus resultierende mögliche klinische Anwendungen von molekularen Markern und zielgerichteten Therapien auf.

Abstract

Urothelial bladder cancer is characterised by high recurrence and progression rates despite multimodal treatment. Only slight improvements have been achieved during the last decades. The current histopathological classification and clinical risk stratification tools are inaccurate. Hence, a better understanding of the tumour biology is essential for the improvement of patient care. The molecular characterisation of bladder cancer may be translated into useful diagnostic and predictive biomarkers. Many potential therapeutic targets have been identified such as FGFR3 (Fibroblast growth factor receptor 3), HER2 (human epidermal growth factor receptor 2) and PD1/PDL1 (programmed cell death-1). They need validation in clinical trials. We now review the molecular biology of urothelial bladder carcinoma and discuss clinical applications of biomarkers and targeted therapies.

Schlüsselwörter

Harnblasenkarzinom - Urothelkarzinom - Biomarker - Molekulare Marker - Zielgerichtete Therapien

Key words

bladder cancer - urothelial cancer - biomarker - molecular marker - targeted therapies

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