Bladder neoplasms: Will a morphological classification become obsolete?

The personalized approach is one of the pillars of the current era in the treatment of bladder cancer. Significant efforts have been made to integrate clinical, pathological, and molecular classifications. The growing need for molecular biomarkers to feed this personalized approach, together with the unprecedented wealth of knowledge of the molecular basis of bladder cancer, has led to a novel approach to this disease.

Translational research allows a better understanding of the early events in the development of urothelial carcinoma in the urinary bladder. Mutations in the KMT2D and KDM6A chromatin-modifying genes confer competitive advantages that drive cells to colonise larger regions of the urothelium. Additional mutations in TP53, PIK3CA, FGFR3, or RB1 genes then trigger the process of a malignant transformation in the urothelium.

In this UROwebinar, we will provide an overview of what could be the expected transition from a morphology-based classification to a combined, molecularly enriched reporting of clinically meaningful parameters with the aim of using a personalized approach to the treatment of urothelial carcinoma.