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Clinical and Genomic Considerations for Variant Histology in Bladder Cancer

  • Genitourinary Cancers (DP Petrylak and JW Kim, Section Editors)
  • Published:
Current Oncology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Urothelial carcinoma demonstrates remarkable plasticity in its ability to differentiate into divergent histologic subtypes in both a pure and mixed form. This review presents the most current data pertaining to bladder cancer with variant histology.

Recent Findings

Recognition of bladder cancer variants has increased profoundly in the past two decades with their inclusion in the pathologic guidelines and increased awareness among pathologists and urologists. Most of the available literature consists of small single-institutional studies, but there is compelling evidence to support deviation from the normal urothelial carcinoma management pathways for certain subtypes. While traditionally diagnosed by microscopic appearance, next-generation sequencing and molecular profiling have enabled identification of genomic markers associated with specific variants that exist in tumors lacking classic histologic hallmarks. This genomic information holds promise for predicting response to specific treatments or even in the development of novel targeted therapies.

Summary

Combining increased awareness of variant histology, its impact on clinical outcomes, and genomic data will result in a more nuanced treatment approach to reduce morbidity and optimize oncologic outcomes for our patients.

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  1. Department of Urology, Division of Surgery, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 1373, Houston, TX, 77030, USA

    Justin T. Matulay, Vikram M. Narayan & Ashish M. Kamat

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Justin T. Matulay and Vikram M. Narayan declare that they have no conflict of interest. Ashish M. Kamat has received research funding from FKD, Merck, BMS, Photocure, Heat Biologics & Telesta; serves/has served on the advisory board for Merck, BMS, Photocure, Theralase, Medac, Astra Zeneca, Ferring, Taris, Combat Medical, Synergo; is President of International Bladder Cancer Network (IBCN) and International Bladder Cancer Group (IBCG); and holder of patent, CyPRIT (Cytokine Predictors of Response to Intravesical Therapy) jointly with UT MD Anderson Cancer Center.

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Matulay, J.T., Narayan, V.M. & Kamat, A.M. Clinical and Genomic Considerations for Variant Histology in Bladder Cancer. Curr Oncol Rep 21, 23 (2019). https://doi.org/10.1007/s11912-019-0772-8

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