Report from the International Society of Urological Pathology (ISUP) Consultation Conference on Molecular Pathology of Urogenital Cancers. II. Molecular Pathology of Bladder Cancer: Progress and Challenges

Warrick JI, Knowles MA, Yves A, Van Der Kwast T, Grignon DJ, Kristiansen G, Egevad L, Hartmann A, Cheng L (2020)

Publication Type: Journal article, Report

Publication year: 2020

Journal

American Journal of Surgical Pathology Lippincott, Williams & Wilkins

DOI: 10.1097/PAS.0000000000001453

Abstract

During the 2019 International Society of Urological Pathology Consultation Conference on Molecular Pathology of Urogenital Cancer, the Working Group on Bladder Cancer presented the current status and made recommendations on the diagnostic use of molecular pathology, incorporating a premeeting survey. Bladder cancers are biologically diverse and can be separated into "molecular subtypes," based on expression profiling. These subtypes associate with clinical behavior, histology, and molecular alterations, though their clinical utility has not been demonstrated at present and use in bladder cancer is not recommended. Mutations in the TERT promoter are present in the majority of bladder cancers, including the noninvasive stage of tumor evolution, but not in reactive conditions. Mutational analysis of the TERT promoter thus distinguishes histologically deceptive cancers from their benign mimics in some cases. A minority of pathologists employ this test. FGFR3 mutations are common in bladder cancer, and metastatic urothelial carcinoma (UC) with such mutations frequently responds to erdafitinib, an FGFR inhibitor. Testing for FGFR3 alterations is required before using this drug. Metastatic UC responds to immune-oncology (IO) agents in 20% of cases. These are approved as first and second-line treatments in metastatic UC. Several biological parameters associate with response to IO agents, including tumor mutational burden, molecular subtype, and infiltration by programmed death-ligand 1-positive lymphocytes, detected by immunohistochemistry. Programmed death-ligand 1 immunohistochemistry is mandatory before administering IO agents in the first-line setting. In conclusion, much has been learned about the biology of bladder cancer, and this understanding has improved the care of patients with the disease.

Authors with CRIS profile

Arndt Hartmann Lehrstuhl für Allgemeine Pathologie und Pathologische Anatomie

Involved external institutions

Karolinska Institute SE Sweden (SE) Penn State College of Medicine US United States (USA) (US) Centre hospitalier universitaire Henri-Mondor (CHU Henri-Mondor) FR France (FR) Indiana University – Purdue University Indianapolis US United States (USA) (US) University of Toronto CA Canada (CA) St James's University Hospital GB United Kingdom (GB) Universitätsklinikum Bonn DE Germany (DE)

How to cite

APA:

Warrick, J.I., Knowles, M.A., Yves, A., Van Der Kwast, T., Grignon, D.J., Kristiansen, G.,... Cheng, L. (2020). Report from the International Society of Urological Pathology (ISUP) Consultation Conference on Molecular Pathology of Urogenital Cancers. II. Molecular Pathology of Bladder Cancer: Progress and Challenges. American Journal of Surgical Pathology. https://doi.org/10.1097/PAS.0000000000001453

MLA:

Warrick, Joshua I., et al. "Report from the International Society of Urological Pathology (ISUP) Consultation Conference on Molecular Pathology of Urogenital Cancers. II. Molecular Pathology of Bladder Cancer: Progress and Challenges." American Journal of Surgical Pathology (2020).

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