Progress and challenges in CAR-T cell therapy for bladder cancer

Bladder cancer (BC) is a prevalent malignancy of the urinary system worldwide, with a rising global incidence, posing a significant threat to public health. The treatment of advanced and metastatic disease remains particularly challenging. Chimeric antigen receptor T-cell (CAR-T) immunotherapy has demonstrated remarkable efficacy in hematologic malignancies and is increasingly being explored in solid tumors. This review summarizes recent advances in CAR-T cell therapy for BC, focusing on major therapeutic targets, mechanisms of action, and potential combination strategies. Furthermore, we discuss findings from preclinical studies and early-phase clinical trials. Current evidence indicates that CAR-T therapy exhibits promising antitumor activity in BC. However, several critical challenges remain, including optimal target selection, the immunosuppressive tumor microenvironment (TME), and insufficient clinical validation. These findings may guide future translational and clinical investigations in this field.