Predictive Biomarkers for Neoadjuvant Chemotherapy Response in Muscle-Invasive Bladder Cancer: A survey

Bladder cancer is the most prevalent urinary tract malignancy and is associated with the highest treatment cost among cancers. The standard therapy for patients with muscle invasive bladder cancer is the radical cystectomy. Nevertheless, there is a high mortality rate within five years after cystectomy. Neoadjuvant chemotherapy of cisplatin-based combinations have been shown to increase the overall survival of the patients. However, not all patients get benefit from the chemotherapy due to resistance to cisplatin, and there is no reliable biomarker to identify the non-responders. Therefore there is a need to identify chemoresistant patients, by finding cisplatin-response biomarkers, to avoid unnecessary surgery delay and drug toxicity. In this paper, we present a review of the current predictive biomarkers to neoadjuvant chemotherapy response that aim to provide a way of individualized therapy in muscle invasive bladder cancer. Furthermore, we will discuss the effectiveness and limitations of these biomarkers. Finally, future trends in this area of research will be discussed.