Regulation of drug resistance in bladder urothelial carcinoma by tumor aerobic glycolysis.

[BACKGROUND] Bladder urothelial carcinoma (BUC) is one of the most common malignant tumors of the urinary system, and its drug resistance often leads to treatment failure and high mortality. Given the crucial role of tumor aerobic glycolysis in regulating drug resistance in BUC, elucidating its mechanisms is promising for developing novel therapeutic strategies against this clinical challenge.

[MAIN BODY] In this review, we provide a systematic description of the specific mechanisms through which tumor aerobic glycolysis regulates drug resistance of BUC, including improved DNA damage repair mechanisms, regulation of epigenetic changes, induction of tumor immune evasion, activation of resistance-promoting downstream mechanisms and increased drug efflux. Additionally, we discuss the potential of tumor aerobic glycolysis for clinical diagnosis and treatment of BUC.

[CONCLUSIONS] Tumor aerobic glycolysis regulates drug resistance in BUC through multiple pathways. Future research should prioritize the development of biomarkers and targeted therapies against key enzymes and metabolites within these pathways to improve the diagnosis, treatment, and prognosis of drug-resistant BUC.