Dr. Grivas on the Future of Molecular Subtyping in Urothelial Cancer

Petros Grivas, MD, PhD, physician of the Seattle Cancer Care Alliance; associate professor in the Department of Medicine in the Division of Oncology and clinical director of the Genitourinary Cancers Program at the University of Washington School of Medicine; and associate member of the Clinical Research Division at Fred Hutchinson Cancer Center, discusses the future of molecular subtyping in urothelial cancer.

Investigators are trying to get more molecular interrogation and profiling in terms of mutations, fusions, and genomic alteration events in urothelial cancer, says Grivas. Through the use of gene expression profiling, investigators hope to be able to separate urothelial cancer into different molecular subtypes, such as luminal papillary type 1, luminal infiltrated basal subtypes and neuroendocrine subtypes, adds Grivas.

Molecular subtyping is not used in clinical practice today but it is possible for it to be used in the near future, according to Grivas, as there is now a consensus regarding molecular subtyping. Investigators might use that in the design of trials to see whether there clinical utility in separating patients based on molecular subtyping. Molecular profiling needs to be thought about in terms of clinical design in order to see if whether it makes a difference in patients’ treatment allocation and outcomes. These are the trials that investigators will need to conduct down the road, concludes Grivas.