Bladder cancer: The need for translational research in the development of novel therapy

Despite thorough transurethral resection, more than 50% of patients with su perficial bladder tumors will develop recurrence within 5 years, and in 5% to 30% of patients, the new tumor is invasive. Bacillus Calmette-Guerin (BC G) is effective for superficial transitional cell carcinoma. Its mechanism of action remains unclear, although attachment to fibronectin is required. The ability of certain tumors to express proteases may have a profound impa ct on intravesical BCG therapy, Telomerase activity has been found in human bladder tumors and may be useful in detecting these lesions, particularly low-grade tumors, Also, agents that alter the expression of telomerase may be useful in chemoprevention, The mechanisms of BCG action and the actions of telomerase are examples of the basic biologic knowledge that may prove h elpful in treating patients with bladder cancer.