Protein-Based Predictive Biomarkers to Personalize Neoadjuvant Therapy for Bladder Cancer-A Systematic Review of the...

Area of Science:

• Oncology
• Translational Research
• Biomarker Discovery

Background:

• Muscle-invasive bladder cancer (MIBC) patients have poor outcomes despite current neoadjuvant therapies.
• Predictive biomarkers for treatment response in MIBC are lacking in clinical practice due to tumor heterogeneity.
• Existing predictive markers (genomic, transcriptomic) are limited by tumor plasticity.

Purpose of the Study:

• To systematically review the prognostic value of protein-based biomarkers for neoadjuvant therapy response in MIBC.
• To identify protein biomarkers that could overcome tumor heterogeneity challenges.
• To assess the readiness of protein biomarkers for clinical application in MIBC.

Main Methods:

• Systematic literature review following PRISMA guidelines.
• Inclusion of 135 studies published within the last five years.
• Categorization of biomarkers by molecular subtypes, cancer stem cells, cytoskeleton, EMT, apoptosis, and immune cells.

Main Results:

• Protein biomarkers, particularly in a spatial context, show potential to mitigate tumor heterogeneity's impact on prognosis.
• Identified biomarker categories include molecular subtypes, stemness, cytoskeleton, EMT, apoptosis, and immune cells.
• Studies highlight the potential of protein-based markers for predicting response to neoadjuvant treatment.

Conclusions:

• Protein biomarkers offer a promising avenue for personalizing neoadjuvant therapy in MIBC.
• Lack of consensus on methodology, reagents, and scoring hinders reliable biomarker assessment.
• Validation in larger, multicenter cohorts is crucial before clinical implementation for individualizing MIBC treatment.