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Molecular and clinical heterogeneity within the luminal subtype

In 2019, the Bladder Cancer Molecular Taxonomy Group (BCMTG) presented a consensus molecular classification comprising six subtypes of muscle-invasive bladder cancer (MIBC). The non-luminal subtypes were the most consistent with previous models. Subsequent studies in 2019 have revealed molecular heterogeneity among the luminal subtypes and their possible clinical ramifications.

Key advances

  • In 2019, the Bladder Cancer Molecular Taxonomy Group put substantial effort into providing a consensus molecular classification comprising six subtypes of muscle-invasive bladder cancer (MIBC).

  • The consensus classifier contains three luminal subtypes.

  • In 2019, three studies were published in which the luminal subtype could be subdivided further by either immunohistochemistry, long non-coding RNA expression or pathological upstaging.

  • Moreover, tumour samples with variant histology (nested or micropapillary) fall into the luminal subgroup but have an aggressive disease course.

  • Consequently, future subtyping studies should reveal which classification approach is the best for clinical decision-making.

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Fig. 1: Schematic overview of the 2019 classifications of luminal bladder tumours.


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The authors thank J. L. Boormans for helpful suggestions on the manuscript and E. A. Gibb for helpful suggestions on the manuscript and personal communication.

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Correspondence to Ellen C. Zwarthoff.

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The authors declare no competing interests.

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de Jong, J.J., Zwarthoff, E.C. Molecular and clinical heterogeneity within the luminal subtype. Nat Rev Urol 17, 69–70 (2020).

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