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Micropapillary bladder cancer: an evolving biology.
Chiara Lonati1, Claudio Simeone1, Nazareno Suardi1
1Urology Unit, ASST Spedali Civili di Brescia, Department of Medical and Surgical Specialties, Radiological Science and Public Health, University of Brescia, Brescia.
Current Opinion in Urology
|July 20, 2022
Summary
Micropapillary bladder cancer (MPBC) is increasingly diagnosed but does not appear to worsen outcomes when adjusted for clinical factors. Neoadjuvant immunotherapy shows promise for MPBC, unlike neoadjuvant chemotherapy.
Area of Science:
- Uro-oncology
- Oncopathology
- Clinical research
Background:
- Micropapillary bladder cancer (MPBC) is a rare variant of urothelial carcinoma.
- MPBC often presents at advanced stages with a higher propensity for spread.
- Current treatment strategies lack consensus due to limited evidence.
Purpose of the Study:
- To provide a comprehensive review of recent evidence on MPBC.
- To focus on incidence, clinical characteristics, treatment, and prognosis.
- To synthesize current understanding of this specific bladder cancer subtype.
Main Methods:
- Literature review of recent studies on MPBC.
- Analysis of incidence rates and clinical presentation.
- Evaluation of therapeutic options and patient outcomes.
Main Results:
- MPBC incidence is rising, accounting for 2.9-7.6% of bladder cancers.
- Despite aggressive presentation, MPBC outcomes are comparable to pure urothelial carcinoma (pUC) after adjustment.
- Neoadjuvant chemotherapy response is poor; neoadjuvant immunotherapy (Pembrolizumab) shows potential.
Conclusions:
- MPBC incidence is increasing, but adjusted outcomes are similar to pUC.
- Neoadjuvant immunotherapy, particularly Pembrolizumab, may be effective for MPBC.
- Further research is needed to establish optimal therapeutic strategies for MPBC.
