ABSTRACT
The primary treatment of metastatic bladder cancer is cisplatin-based chemotherapy. However, even though it is considered sensitive to chemotherapy the average survival is 15 months and even less if there is an organ metastasis. For these patients 5-year survival rate is 5-20%. Several studies have shown different mutations in muscle invasive bladder cancer. These mutations are being studied as a targeted therapy option for cases where chemotherapy is not sufficient. Although there isn’t a specifically approved treatment model for metastatic bladder cancer, targeted therapy is becoming a significant choice. According to the mutation analysis of The Cancer Genome Atlas (TCGA) project, there are three major pathway abnormalities in metastatic bladder cancer: Regulation of cell cycle, RTK/RAS/PIK3 and chromatin abnormalities. The studies about the treatment of bladder cancers with cell cycle regulators, mTOR inhibitors, and EGFR inhibitors will be highly important in the future. Novel approaches are needed for patients with bladder cancer.