Treatment Paradigms in Bladder Cancer: Clinical Implications of Histological and Molecular Analysis

Despite significant recent advances in characterization of the molecular pathogenesis of bladder cancer, incorporation of these new discoveries into current standard clinical treatment paradigms remains limited. As a result, the treatment of bladder cancer continues to rely heavily on clinical and pathological classifiers of disease that dictate current therapeutic algorithms. Although risk stratification methods for both non-muscle invasive and muscle-invasive bladder cancer can potentially assist in categorizing patients into different treatment groups, there is an urgent need for rapid translation of recent advances in the molecular biology of bladder cancer into standard of care. We review the current clinical treatment paradigms in bladder cancer and discuss opportunities for integration of precision molecular therapy into existing algorithms.