Investig Clin Urol.  2016 Jun;57(Suppl 1):S89-S97. 10.4111/icu.2016.57.S1.S89.

Autophagy and urothelial carcinoma of the bladder: A review

• Chandrasekar T
• Evans CP

• KMID: 2426520
• DOI: http://doi.org/10.4111/icu.2016.57.S1.S89

Abstract

The incidence of urothelial carcinoma of the urinary bladder (bladder cancer) remains high. While other solid organ malignancies have seen significant improvement in morbidity and mortality, there has been little change in bladder cancer mortality in the past few decades. The mortality is mainly driven by muscle invasive bladder cancer, but the cancer burden remains high even in nonmuscle invasive bladder cancer due to high recurrence rates and risk of progression. While apoptosis deregulation has long been an established pathway for cancer progression, nonapoptotic pathways have gained prominence of late. Recent research in the role of autophagy in other malignancies, including its role in treatment resistance, has led to greater interest in the role of autophagy in bladder cancer. Herein, we summarize the literature regarding the role of autophagy in bladder cancer progression and treatment resistance. We address it by systematically reviewing treatment modalities for nonmuscle invasive and muscle invasive bladder cancer.

Keyword

Autophagy; Drug resistance; Urinary bladder neoplasms

MeSH Terms

Antineoplastic Agents/therapeutic use
*Autophagy
Carcinoma, Transitional Cell/*pathology/therapy
Disease Progression
Drug Resistance, Neoplasm
Humans
Neoplasm Invasiveness
Urinary Bladder Neoplasms/*pathology/therapy

Figure

• 

  Fig. 1 Starvation and growth-factor deprivation stimulates cell signaling cascades (the key intermediates identified above) that ultimately result in the initiation of autophagy. The autophagosome matures and is trafficked to lysosomes where it fuses and creates the autolysosome. The autolysosome digests cellular biomass and eliminates toxins, facilitating a host of favorable nutrient and growth conditions. AMPK, AMP-activated protein kinase; mTOR, mechanistic target of rapamycin. Adapted from Farrow JM, et al. Nat Rev Urol 2014;11:508-16, with permission from author C.P.E. [13].

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