Shariat - Figure 55
Nature Article
FIG. 55: T1 bladder cancer is an aggressive disease, and as with other cancers, treatment needs to move to personalized medicine in order to deliver the right therapy for the right tumor at the right time in the right patient. We have seen a revolution in the management and understanding of bladder cancer secondary to The Cancer Genome Atlas[72] and other genetic and epigenetic analyses. Bladder cancer has multiple mutational drivers, has a large mutation load already present in T1 bladder cancer, and therefore some patients may require a multitargeted therapy. There is also intratumoral heterogeneity, shown in other studies, and resistance to standard therapy is common and develops early, leading to combination therapies or to change in strategy early on in management.
References
Cancer Genome Atlas Research Network. Comprehensive molecular characterization of urothelial bladder carcinoma. Nature. 2014;507:315−22 http://doi.org/10.1038/nature12965
