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Molecular Nomograms for Predicting Prognosis and Treatment Response

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Bladder Tumors:

Part of the book series: Cancer Drug Discovery and Development ((CDD&D))

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Abstract

Human bladder cancer constitutes a heterogeneous disease characterized by, among its most common variant in Western societies, urothelial carcinoma (UC), two distinct nosologic entities: These are non muscle-invasive UC (NMIUC) and muscle-invasive UC (MIUC), which present specific management questions and are mediated by different molecular pathologic mechanisms. Logically, if differential molecular machinery can be demonstrated to underpin these pathologic states, theoretically, molecular biomarkers can be discovered to prognosticate disease course or predict susceptibility to therapeutic intervention. Thus, while NMIUC may be managed with some success through endoscopic resection, with or without adjuvant immuno- or chemotherapy (Dalbagni 2007), prediction of recurrence or evolution to MIUC is an essential prognostic challenge, as is prediction of metastatic recurrence post cystectomy in de novo MIUC cases. Finally, selection of chemotherapy among locally advanced inoperable or metastatic cases, as well as in the adjuvant or neoadjuvant settings, presents a compelling need for molecularly guided therapy. In this chapter, we present and discuss the opportunity for molecular biomarkers of prognosis or prediction of therapeutic success, focusing on novel, multiplexed molecular biomarkers rather than single targets, and spotlighting cases where such strategies are tailored to the key clinical climacterics outlined above. Molecular data, or a combination of molecular data and traditional clinicopathologic data (Shariat et al. 2008a), can be used to construct models, which upon validation in large patient cohorts, are capable of contributing important prognostic or predictive information for the management of patients. Loosely defined, such a strategy may be called a nomogram (Shariat et al. 2008b).

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  1. Department of Pathology, University of Michigan School of Medicine, Ann Arbor, MI, USA

    Steven Christopher Smith

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  1. Steven Christopher Smith
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  2. Dan Theodorescu
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Correspondence to Steven Christopher Smith .

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  1. Miller School of Medicine, Dept. Urology & Cell Biology & Anatomy, University of Miami, NW. 10th Avenue 1400, Miami, 33136, Florida, USA

    Vinata B. Lokeshwar

  2. , Department of Urology and Urologic Oncol, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover, 30625, Germany

    Axel S. Merseburger

  3. Klinik für Urologie und Kinderurologie, Universitätsklinikum Schleswig-Holstein, Arnold-Heller-Str. 7, Kiel, 24105, Germany

    Stefan H. Hautmann

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Smith, S.C., Theodorescu, D. (2011). Molecular Nomograms for Predicting Prognosis and Treatment Response. In: Lokeshwar, V., Merseburger, A., Hautmann, S. (eds) Bladder Tumors:. Cancer Drug Discovery and Development. Humana Press. https://doi.org/10.1007/978-1-60761-928-4_9

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  • DOI: https://doi.org/10.1007/978-1-60761-928-4_9

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  • Publisher Name: Humana Press

  • Print ISBN: 978-1-60761-927-7

  • Online ISBN: 978-1-60761-928-4

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