Introduction: Non-muscle invasive bladder cancer (NMIBC)
accounts for nearly 75–80% of newly diagnosed bladder cancers and is marked by
frequent recurrence and a variable risk of progression. Human epidermal growth
factor receptor 2 (HER2) has emerged as a biologically relevant oncogenic
driver in urothelial carcinoma, but its prognostic and therapeutic significance
in NMIBC remains incompletely defined.
Aim: This review synthesises current evidence on HER2
biology, molecular associations, prognostic relevance, and therapeutic
implications in bladder cancer, with a focus on NMIBC.
Results: HER2 overexpression and amplification are enriched
in high-grade tumours, advanced stages, luminal molecular subtypes, and
aggressive histological variants, and are associated with disease progression
and resistance to intravesical BCG therapy. Despite strong biological rationale,
conventional HER2-targeted therapies have shown limited efficacy in urothelial
carcinoma due to heterogeneous expression, discordance between protein
overexpression and gene amplification, and complex downstream signalling. In
contrast, emerging antibody–drug conjugates demonstrate promising clinical
activity, including in tumours with low or heterogeneous HER2 expression.
Conclusion: HER2 represents a clinically meaningful
biomarker and therapeutic target in bladder cancer. Standardised HER2 assessment
integrated with molecular profiling may refine risk stratification and enable
precision-guided therapies, particularly for patients with high-risk or
treatment-refractory NMIBC.
Author(s) Details
Vijayanand Mani
Department of Urology and Renal Transplant, Sri Ramachandra Institute of
Higher Education and Research,
Chennai, Tamil Nadu, India.
Bhavyadeep Korrapati
Department of Urology and Renal Transplant, Sri Ramachandra Institute of
Higher Education and Research, Chennai, Tamil Nadu, India.
Velmurugan
Palaniyandi
Department of Urology and Renal Transplant, Sri Ramachandra Institute of
Higher Education and Research, Chennai, Tamil Nadu, India.
Hariharasudhan Sekar
Department of Urology and Renal Transplant, Sri Ramachandra Institute of
Higher Education and Research, Chennai, Tamil Nadu, India.
Sriram Krishnamoorthy
Department of Urology and Renal Transplant, Sri Ramachandra Institute of
Higher Education and Research, Chennai, Tamil Nadu, India.
Please see the book here :- https://doi.org/10.9734/bpi/mono/978-93-47485-68-8/CH3
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