Due to the poor prognosis of advanced bladder
carcinoma and the insufficient affects of the
chemotherapy agents for this disease, the investigation of the novel genetic and pharmacologic agents including anti-angiogenic agents that can target pathway-specific molecules has been the subject of several publications especially for the last 2 years. Although the clinical trials of these agents are still lacking, the experimental and the preliminary studies are giving hope for the future treatment of advanced bladder
carcinoma.
Sunitinib malate and
sorafenib are the novel food and drug administration (FDA) approved anti-angiogenic agents, which have recently been demonstrated to improve the progression-free survival in patients with metastatic
renal cell carcinoma. The main mechanism of these two drugs are defined as preventing the
tumor growth by the inhibition of angiogenesis and the induction of apoptosis and
necrosis via acting on different types of
vascular endothelial growth factor (
VEGF) such as the several agents which have been demonstrated to be beneficial for bladder
carcinoma. According to this knowledge we suggest that these two new agents may also increase the progression-free survival of the patients with advanced bladder
carcinoma due to their anti-angiogenic and
tumor cell apoptotic effects. We believe that the evaluation of the effects of these agents on
bladder cancer population by clinical, prospective and placebo controlled studies may prove our hypothesis and add critical findings to the literature which is still lacking.