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Novel Strategies and Therapeutic Advances for Bladder Cancer

Matthew I Ehrlich1, Robert D Fox1, Karie D Runcie1

  • 1Division of Hematology & Oncology, Columbia University Irving Medical Center, New York, NY 10032, USA.

Cancers
|July 12, 2025
PubMed

Insights

Novel treatments are rapidly changing bladder cancer care. Research focuses on bladder-sparing options for muscle-invasive bladder cancer (MIBC) and advanced therapies for metastatic disease.

Area of Science:

  • Oncology
  • Urology

Background:

  • Bladder cancer treatment has seen significant advancements.
  • Novel therapeutic strategies are emerging for various stages of bladder cancer.

Purpose of the Study:

  • To review recent clinical trials and therapeutic advances in bladder cancer treatment.
  • To summarize novel strategies and ongoing research in bladder cancer therapy.

Main Methods:

  • Comprehensive literature review of recent and ongoing clinical trials (2020 onwards).
  • Focus on novel treatments and therapeutic strategies for bladder cancer.

Main Results:

  • For muscle-invasive bladder cancer (MIBC), neoadjuvant chemotherapy with perioperative immunotherapy is standard for cisplatin-eligible patients; guidelines are lacking for cisplatin-ineligible patients.
  • Investigational strategies for MIBC include combinations of chemotherapy, immunotherapy, radiation, antibody-drug conjugates (ADCs), targeted agents, intravesical treatments, and personalized vaccines, with bladder-sparing approaches being studied.
  • In advanced/metastatic settings, enfortumab vedotin plus pembrolizumab is now first-line, replacing platinum-based chemotherapy. Investigational options for progression include newer immunotherapies, ADCs, small molecule inhibitors, and cellular therapies.

Conclusions:

  • The therapeutic landscape for bladder cancer has dramatically evolved recently.
  • Ongoing trials aim to establish bladder-sparing approaches for MIBC and novel systemic therapies for advanced disease.
Keywords:
bladder cancerbladder-sparingnovel therapiestrimodality therapyurothelial carcinoma

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