Despite years of slow progress, muscle invasive bladder cancer (MIBC) is finally entering the era of molecularly guided targeted therapy. However, tumor heterogeneity is high in MIBC and may impact treatment response and resistance. The objective of this review is to dissect recent insights into inter- and intratumor heterogeneity (ITH) in MIBC, with emphasis on the clinical implications of this heterogeneity for biomarker-driven strategies and the development of new therapies.

Statins are one of the most commonly prescribed medications for hypercholesterolemia worldwide, with 1 in 4 Americans over 45 taking a daily statin [1]. Statins lower cholesterol levels by inhibiting the 3-hydroxy-3-methylglutaryl-coenzyme A enzyme at the rate limiting step in the mevalonate pathway of cholesterol synthesis [2]. Recent research has focused on the antineoplastic role of statins through their impact on cell proliferation, inflammation, membrane organization, and steroidogenesis [3].

In this special edition of Urologic Oncology, we are addressing the effects of androgen deprivation therapy (ADT) for men with prostate cancer. The contributors to this edition were invited based their areas of expertise and willingness to present updated and practical information for providers involved in the care of prostate cancer patients. Drs. Melloni and Roe present current data on androgen deprivation therapy and cardiovascular disease. Management of bone and metabolic effects is reviewed by Drs.