In 2020, Martin was among the ~204,000 people in Europe diagnosed with bladder cancer.[1] Specifically, Martin was diagnosed with metastatic urothelial carcinoma (mUC), which means that as well as the devastating physical burden of his disease,[2] he faces a 5-year survival rate of ~6.4%.[3]
The patient described is fictional and has been used for illustrative purposes only.
There are various types of bladder cancer:[5]
which begins in the urothelial cells of the urinary tract and accounts for ~90% of bladder cancers
which begins in squamous cells in the bladder lining and accounts for ~4% of bladder cancers
which develops from glandular cells and accounts for ~2% of bladder cancers
UC, which is also known as transitional cell carcinoma (TCC), can be located in the lower urinary tract (bladder and urethra) or the upper urinary tract (pyelocaliceal cavities and ureter).[4][6]
Renal pelvis Ureter
Bladder Urethra
Adapted from Fairview, 2021; Rouprêt et al. 2018; American Cancer Society, 2021.[4][6][7]
In Europe in 2020, there were ~204,000 new cases of bladder cancer,[1] and ~67,000 deaths.[11]
Europe has amongst the highest incidence rate, and by far the highest mortality rate for bladder cancer worldwide.[8] This is expected to increase by 2030, in part due to the aging European population.[12]
Adapted from International Agency for Research on Cancer/World Health Organization, 2020.[13]
In Western Europe, bladder cancer is approximately three times more common in men than in women and three times more men die from it.[14]
To achieve this, we put our focus where we can make the most difference to patients, partners, and the entire oncology community. Because anything average is unacceptable.
The molecular biomarkers and pathways involved in bladder cancer are key to understanding its biological heterogeneity and identifying specific subtypes that can be used to predict clinical outcomes.[18][19]
24% | 8% | 15% | 15% | 35% | 3% | |
Luminal papilary | Luminal non-specified | Luminal unstable | Stoma-rich | Basal/squamous | Neuroendocrine-like | |
Differentiation | Urotheilal/Lumina | Basal | Neuroendocrine | |||
Oncogenic mechanisms | FGFR3+PPARG+CDKN2A- | PPARG+ | PPAR+GE2F3+,ERG82+Genomic Instability cellcycle+ | EGFR+ | TP53-, RB1-, Cell cycle+ | |
Mutations | FGFR3 (40%) KDM6A (38%) | ELF3 (35%) | TP53 (76%) ERCC2 (22%) TTMB+APOBEC+ | TP53 (61%) RB1 (25%) | TP53 (61%) RB1 (25%) | |
Stromal inflitrate | Fibroblasts | Smooth muscle Fibroblasts Myofibroblast | Fibroblasts Myofibroblast | |||
Immune infiltrate | B cells | CD8 T cells NK cells | ||||
Histology | Papillary morphology (59%) | Micropapillary variants (36%) | Squamous differentiation (42%) | Neuroendocrine differentiation (72%) | ||
Clinical | T2 stage + | Older patients+(80%) | Woman +T3/T4 stage + | |||
Median overall survival (years) | 4 | 1.8 | 2.9 | 3.8 | 2.1 | 1 |
APOBEC=apolipoprotein B mRNA editing catalytic polypeptide-like; CD8 T cells=cytotoxic T lymphocytes; CDKN2A=cyclin-dependent kinase inhibitor 2A; E2F3=gene encoding E2F transcription factor 3; EGFR=epidermal growth factor receptor; ELF3=gene encoding E74 like ETS transcription factor 3; ERBB2=gene encoding receptor tyrosine-protein kinase erbB-2; ERCC2=gene encoding XPD protein; FGFR=fibroblast growth factor receptor; KDM6A=gene encoding lysine-specific demethylase 6A; NK cells=natural killer cells; PPARG=peroxisome proliferator-activated receptor gamma; RB1=gene encoding pRB tumour suppressor; STAG2=gene encoding cohesin subunit SA-2; T2=tumour growth into muscle; T3=tumour growth into fat layer; T4=tumour growth outside of the bladder; TMB=tumour mutational burden; TP53=gene encodes p53.
Adapted from Kamoun A et al. 2020.[18]
* Based on a study of sequencing data from 4,853 cancers of various types, of which urothelial carcinomas (cancers of the renal pelvis [21 cases], ureter [6], bladder [90], and not otherwise specified [9]) comprised 126 cancers.[21]
Adapted from National Cancer Institute. 2021.[3]
At Janssen Oncology, our purpose is to make cancer a manageable and, ultimately, curable condition. We’re in pursuit of better outcomes for patients, their families, and the entire oncology community.
ERBB2, Erb-B2 receptor tyrosine kinase 2; BRAF, B-Raf. CCND1, cyclin D1. CTLA-4, cytotoxic T-lymphocyte-associated protein 4. FGFR, fibroblast growth factor receptor. ICI, immune checkpoint inhibitor. MDM2, mouse double minute 2. mUC, metastatic urothelial carcinoma. PIK3CA, phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha. PTEN, phosphatase and tensin homolog. TCC, transitional cell carcinoma. TNM, tumour-node-metastasis. TSC1, TSC complex subunit 1. TURBT, transurethral resection of the bladder tumour. UC, urothelial carcinoma.
Date of preparation: June 2021 | CP-230391