Metabolic landscape in bladder cancer

Purpose of review This review examines the existing literature on metabolic pathways associated with bladder cancer (BC) and investigates four domains: (1) diagnoses, (2) cancer classification (staging & grading), (3) tracking, and (4) treatment. Recent findings A systematic search of relevant databases identified studies meeting predefined inclusion criteria. A diverse array of metabolic pathways was found to hold significant biological and clinical relevance to BC, with particular emphasis on amino acid (AA), lipid, nucleic acid (NA), and bioenergetic pathways. Recent studies have elucidated utilities for metabolomics in diagnosis of BC, staging and grading the disease, monitoring progression or recurrence, and informing treatment strategies. Specifically, fatty acids were observed to be upregulated by as much as 90-fold in studies focused on BC diagnosis, alongside the upregulation of AA metabolites. Metabolites such as AA, lipids, and aldehydes showed potential as diagnostic biomarkers for BC. NA metabolites were particularly effective in monitoring BC status postsurgical resection. Furthermore, metabolites from lipid, bioenergetic, and AA pathways demonstrated utility in predicting tumor cell sensitivity to chemotherapy. Summary A broad spectrum of metabolic pathways and metabolites offers significant potential for applications in the diagnosis, staging, monitoring, and treatment of BC. These findings underscore the promise of metabolomics as a valuable tool in improving BC management and patient outcomes.