Non-muscle invasive bladder cancer: a modern look at biomarkers

The algorithm for making therapeutic decisions for the treatment of patients with musculoskeletal noninvasive bladder cancer (NMIBC) is still a challenge in clinical practice, since prognostic biomarkers of the response to treatment are still under study. In addition to the risk factors identified by the EORTC, histological features are also key variables that can affect the recurrence and progression of bladder cancer. Like muscle-invasive cancer, NMIBC is a heterogeneous disease characterized by genomic instability, varying mutation rates and a wide range of protein expression in tissues. In this review, we have summarized the latest data on prognostic and prognostically significant tissue biomarkers in NMIBC, in addition to morphological parameters, in terms of their impact on the biology of the tumor and, consequently, on its behavior during treatment. The review provides data on the most common molecular events associated with relapse and progression, and discusses the relationship between available treatments and molecular factors that can predict clinical response.