Prospects for precision therapy of bladder urothelial carcinoma

Introduction: In cancer, precision medicine, frequently referred to as precision oncology, implies the use of specific information about a person’s tumor to assist diagnosis, guide treatment, find out how well treatment is working, or if it is relevant to patient’s prognosis. Area covered: Molecular classification of bladder cancer as the bases for cancer therapy, immunotherapy and algorithms on how to use the different drugs in these patients, and other emerging target related therapies from relevant clinical trials. Expert commentary: Standard therapy relies on chemotherapy, but results associated with chemotherapy are poor. Recently introduced checkpoint inhibitors, anti-PD1 and anti-PDL1 antibodies, represent a major advance for treating advanced/metastatic bladder urothelial carcinoma. Nevertheless, results are far from perfect with many patients gaining no advantage with the use of these agents. In previously treated and in cisplatin ineligible patients, these agents outperformed standard chemotherapy in terms of overall survival.