Aristolochic Acid and Immunotherapy for Urothelial Carcinoma: Directions for unmet Needs
1
Department of Nephrology, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
2
Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan
3
Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
4
Department of Medical Imaging and Radiological Science, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
5
Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan
6
Department of Medical Education, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan
*
Authors to whom correspondence should be addressed.
Int. J. Mol. Sci. 2019, 20(13), 3162; https://doi.org/10.3390/ijms20133162
Received: 12 May 2019
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Revised: 23 June 2019
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Accepted: 25 June 2019
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Published: 28 June 2019
(This article belongs to the Special Issue Molecular Research Efforts in Urothelial Carcinoma)
Urothelial carcinoma of the bladder (UCB) and upper tracts (UTUC) used to share management with similar principles. However, their genetic and epigenetic differences along with different responses to immunotherapy were recently identified, which are reminiscent of their distinct etiologies. Different from the variety of environmental factors relating to UCB, UTUC is best known for its close relationship with exposure to aristolochic acid (AA). AA is believed to cause its carcinogenicity through forming DNA adducts of deoxyadenosine-aristolactam, as well as A:T → T:A transversions in the TP53 tumor suppressor gene. Since recent findings suggested that cancers with higher somatic mutations are associated with better treatment responses upon immune checkpoint blockade, UTUC and AA-related biomarkers reasonably serve as good candidates, as well as a potential prognostic predictor for the flourishing immunotherapy. This review covers the current state of the literature on the clinical response of UTUC and UCB receiving immunotherapy and points out directions for refinement regarding patient selection.
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Keywords:
upper tract urothelial carcinoma; urothelial carcinoma of the bladder; aristolochic acid; immune checkpoint inhibitors; mutation load
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MDPI and ACS Style
Yang, H.-Y.; Yang, C.-C.; Wu, C.-Y.; Wang, L.-J.; Lu, K.-L. Aristolochic Acid and Immunotherapy for Urothelial Carcinoma: Directions for unmet Needs. Int. J. Mol. Sci. 2019, 20, 3162. https://doi.org/10.3390/ijms20133162
AMA Style
Yang H-Y, Yang C-C, Wu C-Y, Wang L-J, Lu K-L. Aristolochic Acid and Immunotherapy for Urothelial Carcinoma: Directions for unmet Needs. International Journal of Molecular Sciences. 2019; 20(13):3162. https://doi.org/10.3390/ijms20133162
Chicago/Turabian StyleYang, Huang-Yu, Chih-Chao Yang, Chao-Yi Wu, Li-Jen Wang, and Kun-Lin Lu. 2019. "Aristolochic Acid and Immunotherapy for Urothelial Carcinoma: Directions for unmet Needs" International Journal of Molecular Sciences 20, no. 13: 3162. https://doi.org/10.3390/ijms20133162
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