The Emerging Role of B Cells and Tertiary Lymphoid Structures in Bladder Cancer

Area of Science:

• Uro-oncology
• Immunology
• Cancer Research

Background:

• B cells and tertiary lymphoid structures (TLS) are key components of the tumor immune microenvironment.
• Their precise roles in urothelial cancer, particularly non-muscle-invasive bladder cancer (NMIBC), are still being elucidated.
• Understanding these components is crucial for developing novel cancer therapies.

Purpose of the Study:

• To comprehensively review emerging literature on B cells and TLS in urothelial cancer.
• To explore the prognostic and predictive potential of B cells and TLS in bladder cancer.
• To discuss the implications for immunotherapy and intravesical treatments.

Main Methods:

• Literature review of recent studies on B cells and TLS in urothelial cancer.
• Analysis of findings related to muscle-invasive bladder cancer (MIBC) and NMIBC.
• Synthesis of data on immunotherapy and Bacillus Calmette-Guérin (BCG) treatment responses.

Main Results:

• Certain B cell subsets and TLS in MIBC correlate with better outcomes and immunotherapy response.
• The role of TLS in NMIBC is less clear, potentially indicating more aggressive disease but also improved outcomes with intravesical BCG.
• TLS are emerging as potential predictive and prognostic biomarkers for urothelial cancer patients.

Conclusions:

• B cells have a complex, dual role (anti- or pro-tumor) in the urothelial tumor microenvironment.
• Activated B cells forming TLS enhance response to immunotherapy.
• Therapeutic strategies to induce TLS in 'cold' tumors are under investigation.