Identification of molecular targets in urologic oncology.

OBJECTIVES: Molecular targets in cancer diagnosis and therapy have come to the fore of the oncology field in the last decade. Their identification is rooted in basic science investigation and enhanced knowledge in the fields of genetics, biochemistry, molecular and tumor biology, and pathology among others.
METHODS: A medical literature search in English using MEDLINE/PUBMed was performed on the topics of molecular targets, targeted therapy, and biomarkers in the areas of bladder, prostate, and renal cancers. This information was analyzed and combined with the author's personal knowledge in the identification and development of molecular targets. Data is included from the author's laboratory regarding examples of target development and clinical translation.
RESULTS: Molecular targets are often biomarkers; either prognostic ones that reflect the natural history of the cancer or predictive ones that reflect the impact of a therapy. Molecular targets in urologic cancer may arise from four sources: the host, the tumor, as a result of a treatment, or associated with a specific disease stage. Understanding the continuum of targets through the progression of a urologic cancer is central to the translational applications of diagnostics, individualized medicine and targeted therapeutics. Urologists are most familiar with targeted therapy in renal cancer with the introduction of tyrosine kinase inhibitors. Yet, herein are examples of biomarkers and targets across the spectrum of urologic tumors, stages and treatments.
CONCLUSIONS: Identification of events, signals, and pathways in urologic cancer are opportunities to develop biomarkers and targets for diagnosis and treatment.