Immuno · Published 2026-05-25 · DOI 10.3390/immuno6020036
Akshayaa Manikandan, Charles Emmanuel Jebaraj Walter, Sankari Durairajan, Natarajan Kumaresan, Anandan Balakrishnan, Ashwini Saravanan, Jezra Emmanuel Walter, Thanka Johnson
Bladder cancer worldwide has seen a sharp rise, making it a significant global health concern. Recurrence monitoring is the main concern in treating the disease, and drug resistance follows suit. Treatment options include first-line medications, adjuvant therapy with BCG (Bacillus Calmette–Guérin) instillations, and combination therapies targeting the PD-1/PD-L1 axis. It has varying 5-year relative survival rates depending on the stage at diagnosis. Despite initial treatment success, resistance often develops, leading to relapse. Resistant to standard treatment is often due to immune landscape changes that are controlled by the most aberrant genes in bladder cancer, which also have a hold in the immune environment of the bladder. Dysregulation of FGFR3 (Fibroblast Growth Factor Receptor 3) in bladder cancer contributes to cell proliferation and metastasis. Simultaneously, the alterations in EGFR (Epidermal Growth Factor Receptor) regulation are linked to cell migration and resistance to treatment. FGFR3 in non-muscle invasive bladder cancer and EGFR in muscle-invasive bladder cancer are central elements in triggering various signaling pathways that contribute to chemoresistance. Concentrating the roles of both genes within the bladder tumour, they present opportunities not only as therapeutic targets but also as potential points of resistance and monitoring for recurrence. Exploring FGFR3 and EGFR to enhance treatment efficacy when combined with ICIs and developing markers into reliable diagnostic tools for recurrence, ultimately aiming for improved patient well-being, is the key aspect we propose to target from this narrative.
Abstract from DOAJ. Public domain (CC0 1.0).
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Manikandan, A., Walter, C., Durairajan, S., et al. (2026). Potential Target Line, FGFR3, EGFR and Immune Checkpoint Axis for Bladder Cancer Therapy. Immuno. https://doi.org/10.3390/immuno6020036