The role of MDM2-NBS1 protein interaction in bladder cancer | Example Health Essay

1. Bladder cancer
Bladder cancer arises from the epithelial lining (i.e. the urothelium) of the urinary bladder (Van Batavia et al., 2014). It is the ninth most common cause of cancer death in Europe (Antoni et al., 2017). Approximately 70% of all newly diagnosed bladder cancer cases are non-muscle invasive (NMIBC), including stage Ta, T1 and carcinoma in situ (CIS) (Nepple and O’Donnell, 2009). With optimal treatment, there is a 90% 5-year survival rate for non muscle invasive bladder cancer (NMIBC) and 40-60% for organ-confined muscle-invasive disease (MIBC) (T2-3) (Figure 1) (Cancer Research UK). However, disease recurrence continues to pose a significant clinical challenge.
For non-muscle-invasive bladder cancer
, the standard treatment is complete resection of the tumour followed by intravenous chemotherapy or, in more high-risk cases, Bacillus Calmette-Guérin (BCG) immunotherapy (Kawai et al., 2013). For muscle-invasive bladder cancer, the treatment regimen involves neoadjuvant chemotherapy followed by radical cystectomy or bladder-preserving treatment with chemoradiation (El-Taji et al., 2016). Patients with advanced bladder cancer are treated with systemic cisplatin-based chemotherapy, or immunotherapy if first-line chemotherapy cannot control the disease (Farina et al., 2017). Recent genomic analyses refined the classification of molecular subtypes of bladder cancer and identified novel opportunities for therapeutic development (Knowles and Hurst, 2015; Kamat et al., 2016).  

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