Will the 40-gene expression classifier predict responders to EGFR targeted chemotherapy for the invasive bladder cancer patients?

Bladder cancer (BC) is the second most common genitourinary malignancy and the fourth most common cancer in the US, and costs over an estimated $4 billion annually in the US alone. BC ranks amongst the most expensive cancer treatment to date. Most patients have curable transitional cell carcinoma and non-muscle invasive BC (NMIBC). Only approximately 30% of NMIBC patients progress to muscle-invasive BCs (MIBC), however, about 50% of these patients develop metastases within 2 years after cystectomy, and about half of patients die within 5 years. MIBC, which are notorious as heterogeneous and hard-to-treat cancers, do not effectively respond to adjuvant chemotherapy generally associated with a poor prognosis, causing most BC deaths (1).