The evolving genomic landscape of urothelial carcinoma

Alexander P. Glaser, Damiano Fantini, Ali Shilatifard, Edward M. Schaeffer, Joshua J. Meeks*

*Corresponding author for this work

Research output: Contribution to journalReview article

40 Scopus citations

Abstract

Survival of patients with urothelial carcinoma (including bladder cancer and upper tract urothelial carcinoma) is limited by our current approaches to staging, surgery, and chemotherapy. Large-scale, next-generation sequencing collaborations, such as The Cancer Genome Atlas, have already identified drivers and vulnerabilities of urothelial carcinoma. This disease has a high degree of mutational heterogeneity and a high frequency of somatic mutations compared with other solid tumours, potentially resulting in an increased neoantigen burden. Mutational heterogeneity is mediated by multiple factors including the apolipoprotein B mRNA editing enzyme catalytic polypeptide family of enzymes, smoking exposure, viral integrations, and intragene and intergene fusion proteins. The mutational landscape of urothelial carcinoma, including specific mutations in pathways and driver genes, such as FGFR3, ERBB2, PIK3CA, TP53, and STAG2, affects tumour aggressiveness and response to therapy. The next generation of therapies for urothelial carcinoma will be based on patient-specific targetable mutations found in individual tumours. This personalized-medicine approach to urothelial carcinoma has already resulted in unique clinical trial design and has the potential to improve patient outcomes and survival.

Original languageEnglish (US)
Pages (from-to)215-229
Number of pages15
JournalNature Reviews Urology
Volume14
Issue number4
DOIs
StatePublished - Apr 1 2017

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ASJC Scopus subject areas

  • Urology

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