Cancer-associated Fibroblasts in Bladder Cancer: Origin, Biology, and Therapeutic Opportunities

Autores de IDIVAL

• 

  Belén Caramelo Hernández

  Autor

Autores ajenos al IDIVAL

• Zagorac S
• Corral S
• Marqués M
• Real FX

Unidades

• ANATOMÍA PATOLÓGICA Y PATOLOGÍA MOLECULAR

  

  Investigador Responsable

  José Javier Gómez Román

Abstract

Context: Bladder cancer (BLCA) is a highly prevalent tumour and a health problem world-wide, especially among men. Recent work has highlighted the relevance of the tumour microenvironment (TME) in cancer biology with translational implications. Cancer -associated fibroblasts (CAFs) are a prominent, heterogeneous population of cells in the TME. CAFs have been associated with tumour development, progression, and poor progno-sis in several neoplasms. However, their role in BLCA has not yet been exploited deeply.Objective: To review the role of CAFs in BLCA biology and provide an understanding of CAF origin, subtypes, markers, and phenotypic and functional characteristics to improve patient management.Evidence acquisition: A PubMed search was performed to review manuscripts published using the terms "cancer associated fibroblast'' and "bladder cancer"or "urothelial can-cer". All abstracts were reviewed, and the full content of all relevant manuscripts was analysed. In addition, selected manuscripts on CAFs in other tumours were considered.Evidence synthesis: CAFs have been studied less extensively in BLCA than in other tumours. Thanks to new techniques, such as single-cell RNA-seq and spatial transcrip-tomics, it is now possible to accurately map and molecularly define the phenotype of fibroblasts in normal bladder and BLCA. Bulk transcriptomic analyses have revealed the existence of subtypes among both non-muscle-invasive and muscle-invasive BLCA; these subtypes display distinct features regarding their CAF content. We provide a higher -resolution map of the phenotypic diversity of CAFs in these tumour subtypes. Preclinical studies and recent promising clinical trials leverage on this knowledge through the com-bined targeting of CAFs or their effectors and the immune microenvironment.Conclusions: Current knowledge of BLCA CAFs and the TME is being increasingly applied to improve BLCA therapy. There is a need to acquire a deeper understanding of CAF biology in BLCA.Patient summary: Tumour cells are surrounded by nontumoural cells that contribute to the determination of the behaviour of cancers. Among them are cancer-associated fibroblasts. The "neighbourhoods"established through these cellular interactions can now be studied with much greater resolution. Understanding these features of tumours will contribute to the designing of more effective therapies, especially in relationship to bladder cancer immunotherapy.& COPY; 2023 The Author(s). Published by Elsevier B.V. on behalf of European Association of Urology. This is an open access article under the CC BY-NC-ND license (http://creative-commons.org/licenses/by-nc-nd/4.0/).

Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.

Keywords

• Bladder cancer; Chemotherapy; Fibroblasts; Immune checkpoint inhibitors; Immunotherapy; Molecular subtypes; Signatures; Single-cell RNA-seq; Tumour microenvironment; Urothelial carcinoma