In an accompanying paper, Mattias Höglund discusses on what is a bladder cancer molecular subtype. He emphasizes the need to consider the aim of tumor classification, which is obviously critical to the approach. He also focuses on considering primarily the identity features of the neoplastic cells. Here, we provide a counterpoint. While largely agreeing with his views, we underline that other parameters that may vary in a spatial or temporal scale, and the tumor microenvironment, can also provide relevant information to render tumor classifications clinically useful. Furthermore, tumor heterogeneity and evolution during the disease course - natural or under therapeutic pressure - should be considered.
Bladder cancer (Amsterdam, Netherlands). 2023 Dec 13*** epublish ***
François Radvanyi, Francisco X Real, David McConkey
Equipe Oncologie Moléculaire, Equipe Labellisée Ligue Contre le Cancer, CNRS, UMR144, Institut Curie, PSL Research University, Paris, France., Epithelial Carcinogenesis Group, Spanish National Cancer Research Centre-CNIO, Madrid, Spain., Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD, USA.