The deadliness of muscle invasive bladder cancer has made the development of new diagnostic and treatment methods imperative. One strategy involves the use of molecular genetic testing to subtype tumors for aggressiveness. But now a new study published in the Journal of Urology, has found that molecular subtyping of bladder tumors was consistently outperformed by standard tests that pathologists have long used to characterize cancer as low- or high-grade and determine the extent of its invasion into the bladder wall and beyond. Molecular Subtyping Molecular subtyping involves the use of RNA sequencing (RNA-Seq) to compile databanks on gene expression and mutations present in a cancer type to find patterns of gene expression. The data are then used to subtype tumors that “pathologically look similar” but are molecularly different. The theory is that molecular subtypes are better equipped to indicate which cancer is more or less aggressive and to help steer treatment options, e.g., whether to use chemotherapy before surgery to remove a cancerous bladder. Originally, there were two subtypes for muscle invasive bladder cancer (there are now six): Luminal, which betokens better survival; and Basal, which predicts poor prognosis. An Accidental Discovery Information obtained from molecular profiling is no doubt helpful […]