Background
cancers, tumor, bladder tumor, genitourinary malignancy, TURBT, Bladder cancer, bladder cancer
CANCERS, TUMOR, BLADDER TUMOR, RECURRENCE, DISEASE, PROSTATE, BLADDER CANCER, BLADDER CANCER, PRIMARY TUMOR
Bladder cancer is one of the most common cancers in the Western World and the second most common genitourinary malignancy [Prior to the final histological diagnosis during a transurethral resection of the bladder tumor (TURBT) patients undergo a cystoscopy and cytological analysis. Depending on the macroscopical results during cystoscopy and TURBT (invasion, tumor size, single/multiple), as well as the histological diagnosis (high grade/low grade) and the age of the patient, bladder cancer is stratified into low-, intermediate-, high- and very-high risk groups [Patients with low-risk disease undergo an early single adjuvant instillation of a chemotherapeutical agent [Early instillation, induction cycle and maintenance for one year of chemotherapy into the bladder is recommended for intermediate-risk NMIBC by EAU guidelines. Despite the optimal schedule and duration of further intravesical chemotherapy instillation is not defined, it should not exceed one year [There is no specific regimen for intravesical chemotherapy defined by the recent EAU-Guidelines [Until recently, the treatment of bladder cancer, for several years, was limited to surgery and to immunotherapy or chemotherapy. Currently, the extensive analysis of molecular alterations has led to novel treatment approaches [Patient derived organoids (PDO) represent the molecular aspects of the primary tumor and can not only be used to understand the biological basis of the disease, but may also be used to develop new treatment strategies. Organoids are nowadays used for research of different cancers. In the field of urology, there are studies/reports on kidney, prostate, and bladder organoids [Taken together, adjuvant intravesical chemotherapy is considered to reduce the recurrence risk of intermediate-risk bladder cancer. A clearly defined regime of therapy induction and maintenance is still lacking but should not exceed one year. The heterogeneity of non-muscle invasive bladder cancer is related to a high variability of efficacy of chemotherapeutic agents. Even though Epirubicin and MMC are the most frequently used drugs for adjuvant instillation therapy, Docetaxel and Gemcitabine show promising results in existing studies. In vitro drug screens in PDO may predict the response of the agent in vivo, but the implementation of in vitro drug screens in PDO in clinical settings are still pending.