Bladder Cancer

Multiparametric Magnetic Resonance Imaging and Vesical Imaging-Reporting and Data System (VI-RADS) for Bladder Cancer Diagnosis and Staging: A Guide for Clinicians from the American College of Radiology VI-RADS Steering Committee.

European urology · 2026 · PMID 41176432

BACKGROUND AND OBJECTIVE: Staging of bladder cancer (BC) remains a cornerstone of treatment planning, especially in distinguishing non-muscle-invasive BC (NMIBC) from muscle-invasive BC (MIBC). Multiparametric magnetic resonance imaging (mpMRI), together with the Vesical Imaging-Reporting and Data System (VI-RADS) and its neoadjuvant chemotherapy version (nacVI-RADS), has emerged as a noninvasive, standardised tool for local staging and response assessment. Our aim was to provide urologists with a practical, up-to-…

Optimal Management of Muscle-invasive Bladder Cancer: Recommendations from the International Bladder Cancer Group.

European urology · 2026 · PMID 41724648

BACKGROUND AND OBJECTIVE: The management of muscle-invasive bladder cancer (MIBC) is evolving rapidly with the emergence of new perioperative treatments and approaches for bladder preservation. We provide guidance on clinical staging and optimal therapeutic sequencing for patients with MIBC in clinical practice and within the context of clinical trial design. METHODS: The International Bladder Cancer Group (IBCG) convened global experts in bladder cancer to develop recommendations for the management of MIBC and to …

Role of radiotherapy in the management of bladder cancer: Recommendations of the Société française de radiothérapie oncologique, 2025 update.

Cancer radiotherapie : journal de la Societe francaise de radiotherapie oncologique · 2025 · PMID 40839895

We present the recommendations of the Société française de radiothérapie oncologie (SFRO; the French society for radiation oncology) regarding the indications and techniques for external beam radiotherapy for bladder cancer. Together with radical cystectomy, trimodal therapy for well-selected patients is one of the standard-of-care treatments in the management of localized muscle invasive bladder cancer, defined as a maximal trans-urethral resection of the bladder tumour, followed by radiotherapy and concomitant ch…

Bladder Cancer, Version 1.2026, NCCN Clinical Practice Guidelines In Oncology.

Journal of the National Comprehensive Cancer Network : JNCCN · 2026 · PMID 42140269

The NCCN Guidelines for Bladder Cancer provide strategies for the diagnosis, treatment, and follow-up of patients with bladder cancer, which is the sixth most common cancer in the United States. Bladder cancer can be divided into 3 categories along a clinical spectrum: (1) non-muscle-invasive bladder cancer; (2) muscle-invasive bladder cancer; and (3) metastatic bladder cancer, with most patients falling into the category of non-muscle-invasive disease. Thus, the selected content featured in this issue specifically…

SEOM-SOGUG clinical guideline for urothelial cancer (2025).

Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2025 · PMID 40960583

This clinical guideline provides evidence-based recommendations for the diagnosis, staging, and management of bladder cancer across all disease stages. In these guidelines (updated in 2025), we summarize current evidence and available therapies for the medical management of urothelial cancer.

Consensus-Based Development of a Surgical Checklist for Transurethral Resection of Bladder Tumor: An Initiative of the Japanese Society of Urologic Oncology.

International journal of urology : official journal of the Japanese Urological Association · 2026 · PMID 42477956

OBJECTIVE: This study aimed to develop a nationwide, consensus-based surgical checklist to standardize transurethral resection of bladder tumor procedures and documentation. METHODS: In 2025, the Japanese Society of Urologic Oncology convened a working group of 20 bladder cancer specialist urologists to develop a national surgical checklist for transurethral resection of bladder tumors. A 12-member steering committee reviewed available evidence and proposed 30 candidate items. Using a modified Delphi approach, all …

Kidney transplantation from donors with cancer or history of cancer: Transplantation and cancerology committee of Association Française d'Urologie guidelines (CTAFU/CCAFU).

The French journal of urology · 2025 · PMID 41271370

INTRODUCTION: Potential donors for transplantation are screened for malignancies that can be transmitted on to the recipient. The discovery of cancer or a history of cancer often leads to contraindications for organ donation, while in some cases the cancer transmission risk is very low. The current context of organ shortage leads us to reconsider the use of organs from donors with cancer or a history of cancer when the risk of transmission is minimal or less than the risk of death on the waiting list. The Transplan…

Guidelines from the cancer (CCAFU) and infection disease (CI-AFU) committees of the French Association of Urology for the management of adverse events and complications of BCG.

The French journal of urology · 2026 · PMID 41997566

INTRODUCTION: Intravesical instillations of BCG are recommended for the treatment of high-risk non-muscle invasive bladder cancer. However, their prolonged use remains limited by potentially serious adverse events (AEs) or complications. The aim of this article is to provide updated recommendations for the diagnosis and management of AEs or complications of intravesical BCG instillations. MATERIALS: A review of the literature was performed using Medline (http://www.ncbi.nlm.nih.gov) and Embase (http://www.embase.co…

French recommendations of the AFU Oncology Committee for Bladder Cancer: Update 2025.

The French journal of urology · 2025 · PMID 41110705

PURPOSE OF THIS DOCUMENT: The Oncology Committee of the French Urology Association (CCAFU) is proposing a 2025 summary of recommendations' changes for the management of bladder cancer (BCa). METHODS: A systematic review of the literature from July 2024 to September 2025 was conducted by the CCAFU on the evolutions of diagnostic and therapeutic management of BCa evaluating the newly published references with their level of evidence. RESULTS: On NMIBC BCa guidelines: the addition of a new recommendation to the sectio…

Blue versus white light for transurethral resection of non-muscle invasive bladder cancer.

The Cochrane database of systematic reviews · 2026 · PMID 42274003

RATIONALE: Disease recurrence and progression remain major challenges in the treatment of non-muscle invasive bladder cancer (NMIBC). Blue light-enhanced transurethral resection of bladder cancer (TURBT) is an approach to improve staging and achieve a complete resection of NMIBC. Since the first version of this review was published in 2021, new evidence on this topic has become available. OBJECTIVES: To assess the effects of blue light-enhanced TURBT compared to white light-based TURBT in the treatment of non-muscl…

Systematic Review of the Definition of Cure and of Curative-intent Treatments in Early Bladder Cancer.

European urology oncology · 2025 · PMID 41173778

BACKGROUND AND OBJECTIVE: Current guidelines on bladder cancer lack consensus on which outcomes should be used to define cure, the optimal time point for measurement, and which treatments can be given with curative intent in early bladder cancer. Our aim was to determine the optimal definition of cure by assessing cure definitions used in non-muscle invasive bladder cancer (NMIBC) and muscle invasive bladder cancer (MIBC) studies. METHODS: We conducted a systematic literature review via Embase and Medline on July 1…

Prognostic Role of Different T1 Substaging Systems on Recurrence and Progression in Non-muscle-invasive Bladder Cancer: A Systematic Review and Meta-analysis.

European urology oncology · 2026 · PMID 41241655

BACKGROUND AND OBJECTIVE: Different substaging methods have been proposed for risk stratification of T1 non-muscle-invasive bladder cancer; however, no consensus exists. This systematic review and meta-analysis evaluates the prognostic value of various T1 substaging systems. METHODS: A systematic literature search was conducted using the PubMed/Medline, Embase, Scopus, and Web of Science databases to identify reports published until January 2025, following the Preferred Reporting Items for Systematic Reviews and Me…

Adiposity and cancer: systematic review and meta-analysis.

Nature metabolism · 2026 · PMID 42297908

Obesity is a major health challenge. Here we show that body mass index is positively associated with risk of 19 cancers and inversely associated with 3, based on a systematic review and meta-analysis of prospective studies of 25 cancer types. We searched PubMed, EMBASE and Scopus through to 23 April 2025, identifying 226 articles comprising 1.5 million incident cancers. We identified positive associations for leukaemia, non-Hodgkin lymphoma, bladder cancer and glioma, not previously identified by major consensus re…

Update of the EORTC Health-related Quality of Life Modules for Bladder Cancer: Phase 1-2 of the Development Process.

European urology oncology · 2026 · PMID 42191529

BACKGROUND AND OBJECTIVE: To determine whether the existing European Organisation for Research and Treatment of Cancer (EORTC) QLQ-NMIBC24 and QLQ-BLM30 modules remain fit for purpose and to assess health-related quality of life (HRQoL) issues relevant for patients with metastatic bladder cancer (mBC). METHODS: Following the EORTC Quality of Life Group (QLG) guidelines, phase 1 included an expert meeting, five systematic reviews, and interviews with 14 healthcare professionals (HCPs) and 48 bladder cancer (BC) pati…

Pan-cancer multi-omics machine learning defines a lactylation-associated immune-excluded tumor state with proteomic and experimental corroboration.

Computational biology and chemistry · 2026 · PMID 42556016

BACKGROUND: Histone lactylation links lactate metabolism to chromatin regulation, but whether lactylation-program-associated transcriptional patterns delineate recurrent pan-cancer tumor states remains unclear. METHODS: We integrated mRNA, lncRNA, and miRNA profiles from 9712 TCGA tumors across 33 cancer types with GTEx references, six GEO cohorts, IMvigor210, and an institutional clear-cell renal cell carcinoma (ccRCC) cohort used for exploratory DIA-NN proteomic corroboration. Random-effects co-expression meta-an…

Unmet Treatment Need and Challenges Associated with Comparative Evidence Generation in BCG-unresponsive Non-muscle-invasive Bladder Cancer: An Expert Consensus.

European urology oncology · 2026 · PMID 42215335

BACKGROUND AND OBJECTIVE: The overall objective of this modified Delphi panel study was to develop a consensus of European expert clinical opinion on unmet need, clinical evidence generation, and appropriate trial endpoints in Bacillus Calmette-Guérin (BCG)-unresponsive non-muscle-invasive bladder cancer (NMIBC). METHODS: A panel of European clinical experts participated (N = 12, n = 9 at consensus meeting). Consensus statements and topics were developed and tested in online surveys conducted in January-February an…

Intermediate-risk Non-muscle-invasive Bladder Cancer: Recommendations for Definitions, Risk Stratification, Management Strategies, and Clinical Trial Design from the International Bladder Cancer Group.

European urology oncology · 2025 · PMID 41076366

BACKGROUND AND OBJECTIVE: Intermediate-risk (IR) non-muscle-invasive bladder cancer (NMIBC) is a heterogeneous disease, and standardized definitions and risk-guided management are critical for appropriate patient care and clinical trial development. METHODS: A global committee of bladder cancer experts developed IR-NMIBC recommendations. Working groups reviewed literature and drafted recommendations, which were voted on by International Bladder Cancer Group (IBCG) members using a modified Delphi process. During an …

Bladder Preservation After Neoadjuvant Therapy for Muscle-invasive Bladder Cancer in the Current Era: Myth and Reality.

European urology focus · 2026 · PMID 41261008

Bladder preservation after neoadjuvant therapy for muscle-invasive bladder cancer remains investigational. While randomized validation is awaited, growing prospective data, consensus standardization, and biomarker-driven strategies are transforming bladder-sparing strategies from an empirical alternative into a disciplined, evidence-maturing paradigm towards bladder-intact cure.

MRI based unsuperviced clustering on MIBC reveals intratumor heterogeneity phenotypes and neoadjuvant chemotherapy efficacy.

Cancer imaging : the official publication of the International Cancer Imaging Society · 2026 · PMID 41742305

BACKGROUND: To develop and validate a non-invasive imaging-based intratumor heterogeneity (IITH) framework for risk stratification in muscle-invasive bladder cancer (MIBC) and to investigate its association with survival outcomes and molecular subtypes. METHODS: In this retrospective multicenter study, 437 MIBC patients were enrolled (237 patients of discovery cohort and 102 patients of validation cohort predominantly underwent radical cystectomy (RC); 98 patients of NAC cohort received three to four cycles of gemc…

Added value of synthetic MRI in refining biparametric MRI VI-RADS for predicting muscle-invasive bladder cancer.

Abdominal radiology (New York) · 2026 · PMID 41553526

PURPOSE: To evaluate the diagnostic value of synthetic MRI (SyMRI)-derived T1 and T2 values in predicting muscle-invasive bladder cancer (MIBC), and assess the feasibility of integrating them into the biparametric MRI Vesical Imaging-Reporting and Data System (bpVI-RADS). METHODS: This prospective dual-center study included 42 patients (mean age: 71.90 ± 9.70 years, 90.5% male, 23.8% MIBC) with histologically confirmed urothelial carcinoma who underwent bladder MRI. Two radiologists independently assigned bpVI-RADS…

Prognostic value of tumor budding in muscle-invasive urothelial carcinoma of the bladder.

Journal of the Egyptian National Cancer Institute · 2025 · PMID 41320725

BACKGROUND: Bladder cancer is a common malignancy of the urogenital tract worldwide. Almost 20–30% of new cases are muscle-invasive, a complex pathology with significant clinical and biological variability. Despite treatment advances, predicting disease progression remains challenging due to the limitations of traditional prognostic factors. Identifying new markers, such as tumor budding (TB), could offer a promising breakthrough. The aim of this study was to evaluate TB in muscle-invasive urothelial carcinoma (UC)…

A Long Noncoding RNA-based Classifier for Identifying More Aggressive Low-grade Ta Bladder Cancer with Elevated FGFR3 Activity.

European urology oncology · 2026 · PMID 41763905

BACKGROUND AND OBJECTIVE: Low-grade, stage Ta (TaLG) non-muscle-invasive bladder cancer (NMIBC) is generally nonaggressive; yet, some patients experience recurrence or progression. We previously identified long noncoding RNA cluster 2 (LC2) as an aggressive TaLG subgroup via consensus clustering, which required a cohort-level analysis. We developed a single-sample transcriptome classifier for patient-level LC2 identification. METHODS: Using the UROMOL cohort (n = 276) for training/testing and the Hurst (Stage-strat…

Intraoperative Skills for Transurethral Resection of Bladder Tumor: Objective Assessment and Construct Validity of the ENTRY Metrics.

European urology focus · 2026 · PMID 41412888

BACKGROUND AND OBJECTIVE: Transurethral resection of bladder tumor (TURBT) is one of the procedures most often performed by trainee urologists. ENTRY is a cooperative partnership aimed at improving the training of urology residents. Metrics for TURBT were published after a Delphi consensus process involving experts. The aim of this study was to assess the reliability and construct validity (via known-group and convergent validity) of objective metrics for characterizing the intraoperative performance of TUTBT as op…

[Management of ocular adverse events associated with antibody-drug conjugates in the treatment of solid tumors: a consensus statement from Chinese experts (2025 edition)].

Zhonghua zhong liu za zhi [Chinese journal of oncology] · 2026 · PMID 41876197

In recent years, antibody-drug conjugates (ADCs) have achieved remarkable progress in the treatment of solid tumors and are now widely applied in malignancies such as breast cancer, ovarian cancer, cervical cancer, urothelial carcinoma, and non-small cell lung cancer, demonstrating favorable clinical efficacy. However, with their expanding clinical use, safety challenges associated with ADCs have become increasingly apparent. Among these, ocular adverse events have received limited attention in the past but is now …

Comparative analysis of EAU, AUA, and NCCN guidelines for the management of non-muscle invasive bladder cancer.

BMC urology · 2026 · PMID 41526868

BACKGROUND: This study aimed to systematically compare the most recent guidelines from the European Association of Urology (EAU, 2025), American Urological Association (AUA, 2024), and National Comprehensive Cancer Network (NCCN, 2025) for the management of non-muscle invasive bladder cancer (NMIBC). The primary objective was to assess the degree of concordance and identify sources of divergence across 32 predefined clinical decision domains. MATERIALS AND METHODS: This guideline concordance study was conducted acc…

Prognostic value of preoperative systemic immune-inflammation index in patients with bladder cancer undergoing radical cystectomy: a systematic review and meta-analysis.

Frontiers in oncology · 2026 · PMID 42666146

BACKGROUND: To improve risk stratification in patients with bladder cancer (BC) undergoing radical cystectomy (RC), the systemic immune-inflammation index (SII), calculated from routine blood parameters, has attracted attention as a promising prognostic biomarker. This meta-analysis aims to synthesize existing evidence regarding the prognostic utility of SII and to elucidate its potential clinical significance. METHODS: This systematic review and meta-analysis, conducted in accordance with the PRISMA framework, inc…

SEOM-SOGUG clinical guideline for urothelial cancer (2025).

Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2025 · PMID 40960583

This clinical guideline provides evidence-based recommendations for the diagnosis, staging, and management of bladder cancer across all disease stages. In these guidelines (updated in 2025), we summarize current evidence and available therapies for the medical management of urothelial cancer.

Mortality risk in patients with urological malignancies and human immunodeficiency virus (HIV) coinfection: A systematic review and meta-analysis of cohort studies.

Cancer pathogenesis and therapy · 2026 · PMID 42643168

BACKGROUND: The extended survival of people living with human immunodeficiency virus (HIV) (PLWH) has shifted cancer burdens toward urological malignancies. PLWH exhibit unique clinical patterns, including a younger age at diagnosis for renal cell carcinoma and more advanced stage at presentation of prostate and bladder cancers, which are compounded by inequities in health care access and HIV-specific mechanisms such as chronic immunosuppression. METHODS: A systematic search was conducted across five databases (Web…

Xpert bladder cancer detection and monitor in urothelial carcinoma: systematic review and meta-analysis.

Scientific reports · 2026 · PMID 42289472

Xpert Bladder Cancer (BC) is an mRNA-based urine assay for diagnosis and surveillance of urothelial carcinoma. Although previous meta-analyses have examined Xpert, none has evaluated its accuracy in both BC detection and non-muscle-invasive bladder cancer (NMIBC) surveillance, while also exploring its potential role in guiding repeat transurethral resection (re-TURBT) and in the diagnostic evaluation of upper tract urothelial carcinoma (UTUC). We systematically assessed the diagnostic accuracy of Xpert in all these…

Perioperative Immunotherapy in Muscle-Invasive Bladder Cancer: A Systematic Review and Meta-Analysis of Neoadjuvant and Adjuvant Strategies.

Clinical oncology (Royal College of Radiologists (Great Britain)) · 2026 · PMID 42520756

AIMS: To evaluate the efficacy and safety of the perioperative immunotherapy-based regimens. MATERIALS AND METHODS: A systematic search of PubMed/MEDLINE, Embase, Scopus, and the Cochrane Central Register of Controlled Trials was performed from January 2000 to October 2025, with an updated search through June 2026. Eligible studies included randomized trials and prospective clinical studies evaluating neoadjuvant, adjuvant, or combined perioperative immunotherapy-based strategies in patients with MIBC. Outcomes inc…

Stage-specific associations of HER2 overexpression with clinical and pathological features in bladder cancer: a systematic review and meta-analysis.

International urology and nephrology · 2026 · PMID 41876828

BACKGROUND: Human epidermal growth factor receptor 2 (HER2) overexpression is an established oncogenic driver and therapeutic target in several malignancies, but its clinical significance in urothelial carcinoma (UC) of the bladder remains controversial due to disease heterogeneity and lack of standardized assessment. OBJECTIVE: To synthesize evidence on the stage-specific associations of HER2 overexpression with clinicopathological features in bladder UC through a systematic review and meta-analysis. METHODS: We c…

Associations between tertiary lymphoid structure density and immune checkpoint inhibitor efficacy in solid tumors: systematic review and meta-analysis.

Frontiers in immunology · 2024 · PMID 39544934

BACKGROUND: Tertiary lymphoid structures (TLS) play a crucial role in tumor immunity, yet their relationship with the efficacy of immune checkpoint inhibitors (ICI) in cancer therapy is not fully understood. This study aims to systematically evaluate how TLS density influences treatment outcomes in cancer patients receiving ICI therapy. METHODS: The PubMed, Embase, Cochrane Library, and Web of Science databases were searched for eligible studies published before January 22, 2024. Our analysis encompassed odds ratio…

Neoplasms in prune belly syndrome: A novel case of early-onset metastatic bladder carcinoma and systematic review of reported tumors.

Journal of pediatric urology · 2026 · PMID 42263627

PURPOSE: Prune Belly Syndrome (PBS) is a rare congenital malformation complex characterized by cryptorchidism, urinary tract abnormalities and deficiency of the abdominal wall musculature. Although advances in neonatal and reconstructive care have substantially improved survival, the long-term risk of malignancy in this population remains poorly defined. We report a novel case of early-onset metastatic bladder carcinoma in a patient with PBS and perform a systematic review of all tumors described in association wit…

Dietary Fatty Acids and Bladder Cancer Risk: Insights from the PLCO Cancer Screening Trial.

Nutrition and cancer · 2025 · PMID 40237627

This study aimed to evaluate the relationship between the consumption of different dietary fatty acids and the risk of bladder cancer. A quantitative analysis was conducted using data from the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial, which included 101,731 participants. The Cox proportional hazards model was used to calculate hazard ratios (HR) and 95% confidence intervals (CI) for bladder cancer risk in relation to dietary fatty acid intake. During a median follow-up of 11.3 years, 86…

The Local Effects of Systemic Therapies in Urological Oncology: A Systematic Review.

Cancer medicine · 2026 · PMID 42630020

BACKGROUND: Systemic therapies can impact local disease progression in genitourinary malignancies, potentially reducing the necessity for extensive surgery. Understanding these effects is crucial for optimizing treatment approaches in urologic oncology. METHODS: Through PubMed and Scopus databases search up to May 2026, we identified studies focusing on surgical outcomes after systemic therapy in prostate, kidney, testicular, and bladder cancers. RESULTS: In prostate cancer (PC), neoadjuvant hormonal therapy improv…

Immune-Enhancing Nutrition and Outcomes After Radical Cystectomy: A Randomized Clinical Trial.

JAMA network open · 2026 · PMID 42475098

IMPORTANCE: Radical cystectomy for bladder cancer is associated with high complication rates. Evidence supporting perioperative specialized immunonutrition for reducing complications is limited. OBJECTIVE: To determine whether perioperative specialized immunonutrition reduces 30-day complications compared with standard oral nutrition support among adults undergoing radical cystectomy. DESIGN, SETTING, AND PARTICIPANTS: This multicenter, randomized, double-blind, phase 3 clinical trial (SWOG S1600) conducted at 13 U…

Predictive and prognostic biomarkers of Bacillus Calmette-Guérin therapy failure in bladder cancer patients: A systematic review.

Molecular oncology · 2026 · PMID 42703096

High-risk non-muscle invasive bladder cancer (NMIBC) is a common urological malignancy with a high propensity for recurrence (30-40% of patients) despite treatment with Bacillus Calmette-Guérin (BCG) instillations. Identifying patients who are likely to respond or not to BCG therapy before treatment initiation may significantly improve patient outcomes and minimise unnecessary treatments. This systematic review critically assessed the existing literature on the potential of non-invasive biomarkers to predict BCG fa…

Use of Shared Decision-Making in Non-Muscle-Invasive Bladder Cancer: Protocol for a Scoping Review.

JMIR research protocols · 2026 · PMID 42060468

BACKGROUND: With a growing range of treatment options for non-muscle-invasive bladder cancer (NMIBC), the emergence of longitudinal patient-reported quality-of-life data, and an aging population managing the treatment burden of coexisting conditions, there is an increasing need for shared decision-making processes and tools to support urologists and patients in navigating complex treatment decisions. What remains unknown is how shared decision-making is currently incorporated into NMIBC treatment decisions and whic…

Intravesical mitomycin-C administered immediately before transurethral resection of bladder tumor in non-muscle-invasive bladder cancer: Clinical outcomes and molecular predictors from over 3 years of extended follow-up in a phase II trial.

Investigative and clinical urology · 2026 · PMID 42683856

PURPOSE: To evaluate the long-term outcomes and molecular correlates of response after immediate preoperative intravesical chemotherapy (IPeIC) with mitomycin-C (MMC) in patients with non-muscle-invasive bladder cancer (NMIBC). MATERIALS AND METHODS: In this single-center, open-label, randomized phase II trial, 33 patients received two split doses of IPeIC/MMC (40 mg/20 mL), whereas 38 patients underwent transurethral resection of bladder tumor (TURBT) alone. The primary endpoint was 3-year recurrence-free survival…

Adjuvant nivolumab in muscle-invasive urothelial carcinoma: exploratory biomarker analysis of the randomized phase 3 CheckMate 274 trial.

Nature medicine · 2025 · PMID 40775055

Nivolumab monotherapy has been approved for the adjuvant treatment of adult patients with urothelial carcinoma who are at high risk of recurrence after undergoing radical resection of urothelial carcinoma based on results of the phase 3 CheckMate 274 trial, in which adjuvant nivolumab versus placebo demonstrated improvement in the primary endpoint of disease-free survival (DFS) in high-risk muscle-invasive urothelial carcinoma (MIUC). Identification of biomarkers associated with treatment outcomes can help refine p…

Therapeutic landscape of upper tract urothelial carcinoma: Intraluminal agents, perioperative chemotherapy, and immunotherapy.

Urologic oncology · 2026 · PMID 42660692

BACKGROUND: Upper tract urothelial carcinoma (UTUC) is an uncommon genitourinary malignancy with distinct anatomical and clinical challenges. Historically, treatment strategies have been extrapolated from bladder cancer, leaving gaps in evidence for UTUC-specific management. Recent advances in intraluminal drug delivery and systemic therapy have presented new options across localized, locally advanced, and metastatic disease. METHODS: We reviewed prospective trials, retrospective cohort studies, and ongoing studies…

Immune Checkpoint Inhibitor-Associated Uveitis: Insights From Comparative Analyses Across Malignancies and Drug Classes.

American journal of ophthalmology · 2026 · PMID 42229563

PURPOSE: Understanding how the risk of immune checkpoint inhibitor (ICI)-associated noninfectious uveitis (NIU) differs by malignancy and drug class may help understand its pathophysiology and guide targeted ophthalmic surveillance. This study aims to evaluate the comparative risk of ICI-associated NIU across different malignancies and drug classes. DESIGN: Retrospective, multicenter clinical cohort study. SUBJECTS: Adults with metastatic melanoma, lung cancer, renal cell carcinoma (RCC), urothelial carcinoma, hepa…

Urinary protein semi-quantification in immunochemotherapy for bladder cancer: markers of clinical outcomes.

Frontiers in immunology · 2026 · PMID 42639047

OBJECTIVE: PD-1 based immunochemotherapy has improved bladder cancer (BC) outcomes, yet individual responses remain heterogeneous. Low-cost, non-invasive predictive biomarkers are urgently needed. Urinary protein semi-quantification (UPSQ) correlates with BC tumor load, but its predictive value during PD-1 based immunochemotherapy remains unclear. We conducted a post-hoc analysis of the TRUCE-01 (NCT04730219) and TRUCE-02 (NCT04730232) trials to explore the association between UPSQ and clinical outcomes. METHODS: 1…

Fruit and vegetable consumption, dietary and plasma carotenoids and risks of recurrence and progression in patients with non-muscle-invasive bladder cancer.

European journal of nutrition · 2026 · PMID 42627386

PURPOSE: Fruit and vegetable consumption may decrease bladder cancer risk, but research on its relation to outcomes of non-muscle-invasive bladder cancer (NMIBC) is scarce. We investigated the association of (changes in) pre- and postdiagnosis fruit and vegetable consumption, as well as postdiagnosis dietary and plasma carotenoids, with risks of recurrence and progression in patients with NMIBC. METHODS: Data from patients with newly diagnosed NMIBC between 2014 and 2021 from the prospective multi-centre cohort Uro…

Nectin-4 and Trop-2 expression in collecting duct carcinoma: new promising therapeutic targets.

ESMO open · 2026 · PMID 42526179

BACKGROUND: Collecting duct carcinoma (CDC) is a rare and aggressive renal malignancy with limited therapeutic options and no established biomarker-driven strategies. Given its morphologic and embryologic overlap with urothelial carcinoma, we investigated the expression of Nectin-4 and Trop-2, targets of antibody-drug conjugates (ADCs) with proven activity in urothelial cancer. PATIENTS AND METHODS: Tumor samples from 59 patients with CDC who were enrolled in the multicenter CICERONE study (NCT05372302) were centra…

Lifestyle and dietary inflammation scores and risks of recurrence and progression among patients with non-muscle invasive bladder cancer.

Nutrition (Burbank, Los Angeles County, Calif.) · 2026 · PMID 42556054

A healthy lifestyle and diet may improve outcomes of patients with non-muscle invasive bladder cancer (NMIBC), potentially through reducing systemic inflammation. Therefore, this study investigated the association of a post-diagnosis Lifestyle (LIS) and Dietary Inflammation Score (DIS), and high-sensitivity C-reactive protein (hsCRP) with the risks of NMIBC recurrence and progression. Patients with newly diagnosed NMIBC between 2014 and 2021 were recruited for the prospective multi-center cohort UroLife. Lifestyle …

MRI-based deep learning combined with radiomics for the preoperative prediction of lymphovascular invasion in patients with bladder cancer.

Cancer imaging : the official publication of the International Cancer Imaging Society · 2026 · PMID 42277884

BACKGROUND: Lymphovascular invasion (LVI) signifies poor prognosis in bladder cancer, yet reliable preoperative prediction remains challenging, limiting personalized treatment planning. METHODS: In this multi-center retrospective study, 543 bladder cancer patients were enrolled. Of these, 473 patients from two centers were randomly split into training and internal test sets at an 8:2 ratio, while 70 patients from six additional centers constituted an independent external test set. After tumor and peritumoral segmen…

Prognostic value of systemic inflammatory markers in avelumab maintenance for advanced urothelial carcinoma: the multicentric SAILOR analysis.

Scientific reports · 2026 · PMID 42310334

Systemic inflammatory indices have been proposed as prognostic biomarkers in several malignancies; however, their role in patients receiving avelumab maintenance for advanced urothelial carcinoma (aUC) remains poorly defined. This study aimed to evaluate the prognostic impact of inflammatory markers in this context and to develop a composite score for outcome stratification. We retrospectively analyzed patients with aUC who were treated with avelumab maintenance therapy. Systemic inflammatory markers - including th…

Improving long-term monitoring in NMIBC: Digital Uromonitor® (dUM) as a complementary tool to cystoscopy for two-year recurrence risk stratification.

Actas urologicas espanolas · 2026 · PMID 42191068

OBJECTIVE: Non-muscle-invasive bladder cancer (NMIBC) has a high risk of recurrence and requires intensive long-term surveillance. Existing clinical risk models offer limited prognostic accuracy. Molecular urine-based assays may improve prognostic assessment accuracy of future recurrence. This study evaluated whether Digital Uromonitor® (dUM), detecting TERT and FGFR3 mutations via ddPCR, enhances prognostic assessment of two-year recurrence beyond cystoscopy and cytology in a prospective multicenter cohort. METHOD…

Urine Tumor DNA Testing Identifies Recurrence and Monitors Therapy Response in Patients With High-Risk Nonmuscle-Invasive Bladder Cancer Receiving Intravesical Bacillus Calmette-Guérin.

The Journal of urology · 2026 · PMID 42160635

PURPOSE: Intravesical bacillus Calmette-Guérin (BCG) is the preferred treatment for high-risk nonmuscle-invasive bladder cancer. However, many patients recur within the first year despite optimal therapy. Urine tumor DNA (utDNA) offers promise in stratifying therapy response to identify patients who may benefit from treatment intensification or de-escalation. Our study aimed to validate utDNA testing in a multicenter cohort of patients receiving BCG. MATERIALS AND METHODS: Pretreatment/posttreatment urine from pati…

Application Value of Radiomics-Based Machine Learning for Preoperative Risk Stratification of Bladder Cancer: Systematic Review and Meta-Analysis.

Journal of medical Internet research · 2026 · PMID 42285048

BACKGROUND: Some researchers have explored the application of radiomics-based machine learning to detect preoperative muscle invasion, high-grade tumors, human epidermal growth factor receptor 2 expression, and other risk factors for bladder cancer. However, systematic evidence proving its effectiveness remains lacking. OBJECTIVE: This study aimed to evaluate the performance of radiomics-based machine learning in preoperative risk stratification for patients with bladder cancer. These findings could contribute to a…

Optimal Management of Muscle-invasive Bladder Cancer: Recommendations from the International Bladder Cancer Group.

European urology · 2026 · PMID 41724648

BACKGROUND AND OBJECTIVE: The management of muscle-invasive bladder cancer (MIBC) is evolving rapidly with the emergence of new perioperative treatments and approaches for bladder preservation. We provide guidance on clinical staging and optimal therapeutic sequencing for patients with MIBC in clinical practice and within the context of clinical trial design. METHODS: The International Bladder Cancer Group (IBCG) convened global experts in bladder cancer to develop recommendations for the management of MIBC and to …

Multiparametric Magnetic Resonance Imaging and Vesical Imaging-Reporting and Data System (VI-RADS) for Bladder Cancer Diagnosis and Staging: A Guide for Clinicians from the American College of Radiology VI-RADS Steering Committee.

European urology · 2026 · PMID 41176432

BACKGROUND AND OBJECTIVE: Staging of bladder cancer (BC) remains a cornerstone of treatment planning, especially in distinguishing non-muscle-invasive BC (NMIBC) from muscle-invasive BC (MIBC). Multiparametric magnetic resonance imaging (mpMRI), together with the Vesical Imaging-Reporting and Data System (VI-RADS) and its neoadjuvant chemotherapy version (nacVI-RADS), has emerged as a noninvasive, standardised tool for local staging and response assessment. Our aim was to provide urologists with a practical, up-to-…

Guidelines from the cancer (CCAFU) and infection disease (CI-AFU) committees of the French Association of Urology for the management of adverse events and complications of BCG.

The French journal of urology · 2026 · PMID 41997566

INTRODUCTION: Intravesical instillations of BCG are recommended for the treatment of high-risk non-muscle invasive bladder cancer. However, their prolonged use remains limited by potentially serious adverse events (AEs) or complications. The aim of this article is to provide updated recommendations for the diagnosis and management of AEs or complications of intravesical BCG instillations. MATERIALS: A review of the literature was performed using Medline (http://www.ncbi.nlm.nih.gov) and Embase (http://www.embase.co…

Bladder Cancer, Version 1.2026, NCCN Clinical Practice Guidelines In Oncology.

Journal of the National Comprehensive Cancer Network : JNCCN · 2026 · PMID 42140269

The NCCN Guidelines for Bladder Cancer provide strategies for the diagnosis, treatment, and follow-up of patients with bladder cancer, which is the sixth most common cancer in the United States. Bladder cancer can be divided into 3 categories along a clinical spectrum: (1) non-muscle-invasive bladder cancer; (2) muscle-invasive bladder cancer; and (3) metastatic bladder cancer, with most patients falling into the category of non-muscle-invasive disease. Thus, the selected content featured in this issue specifically…

SEOM-SOGUG clinical guideline for urothelial cancer (2025).

Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2025 · PMID 40960583

This clinical guideline provides evidence-based recommendations for the diagnosis, staging, and management of bladder cancer across all disease stages. In these guidelines (updated in 2025), we summarize current evidence and available therapies for the medical management of urothelial cancer.

Consensus-Based Development of a Surgical Checklist for Transurethral Resection of Bladder Tumor: An Initiative of the Japanese Society of Urologic Oncology.

International journal of urology : official journal of the Japanese Urological Association · 2026 · PMID 42477956

OBJECTIVE: This study aimed to develop a nationwide, consensus-based surgical checklist to standardize transurethral resection of bladder tumor procedures and documentation. METHODS: In 2025, the Japanese Society of Urologic Oncology convened a working group of 20 bladder cancer specialist urologists to develop a national surgical checklist for transurethral resection of bladder tumors. A 12-member steering committee reviewed available evidence and proposed 30 candidate items. Using a modified Delphi approach, all …

Enfortumab vedotin monotherapy, enfortumab vedotin plus pembrolizumab, and immune checkpoint inhibitor-based neoadjuvant therapy for muscle-invasive bladder cancer: A systematic review and meta-analysis.

Urologic oncology · 2026 · PMID 42436099

Comparative efficacy among neoadjuvant enfortumab vedotin (EV) monotherapy, EV plus pembrolizumab (EV+P), and immune checkpoint inhibitor (ICI)-based regimens for muscle-invasive bladder cancer (MIBC) is unclear, and we aimed to compare pathological and survival outcomes among these strategies. We searched PubMed, Cochrane, Web of Science, Google Scholar, and ClinicalTrials.gov (January 2015-October 2025) for prospective Phase II or higher trials of ICI- or EV-containing neoadjuvant therapy reporting pathological c…

Body Size and Bladder Cancer Risk: A Pooled Analysis of Prospective Studies From the National Cancer Institute Cohort Consortium.

Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2026 · PMID 41996653

PURPOSE: Body size is an established risk factor for several cancers, but associations with bladder cancer risk remain unclear. METHODS: We pooled data from 2,533,008 participants in 30 international cohort studies to assess associations of BMI, waist circumference, and height with bladder cancer risk. Multivariable Cox regression models, including smoking status, duration, and other confounders, were run separately by cohort and sex, and results combined by random-effects meta-analysis. RESULTS: Incident first pri…

Xpert bladder cancer detection and monitor in urothelial carcinoma: systematic review and meta-analysis.

Scientific reports · 2026 · PMID 42289472

Xpert Bladder Cancer (BC) is an mRNA-based urine assay for diagnosis and surveillance of urothelial carcinoma. Although previous meta-analyses have examined Xpert, none has evaluated its accuracy in both BC detection and non-muscle-invasive bladder cancer (NMIBC) surveillance, while also exploring its potential role in guiding repeat transurethral resection (re-TURBT) and in the diagnostic evaluation of upper tract urothelial carcinoma (UTUC). We systematically assessed the diagnostic accuracy of Xpert in all these…

Prognostic Factors of Trimodal Therapy for Muscle-invasive Bladder Cancer: A Systematic Review and Meta-analysis.

European urology focus · 2026 · PMID 41419363

BACKGROUND AND OBJECTIVE: Trimodal therapy (TMT)-comprising transurethral resection of the bladder tumor, chemotherapy, and radiotherapy-offers a bladder-preserving alternative to radical cystectomy for selected patients with muscle-invasive bladder cancer (MIBC). However, the optimal criteria for patient selection and prognostication remain inadequately defined. A systematic review and meta-analysis was conducted to optimize the selection of MIBC patients who are likely to have better survival outcomes from TMT. M…

Intra-corporeal robot-assisted versus open radical cystectomy: a meta-analysis.

World journal of urology · 2026 · PMID 42525253

OBJECTIVE: To compare the safety and effectiveness between robot-assisted radical cystectomy with intracorporeal urinary diversion (iRARC) and open radical cystectomy (ORC). METHODS: We conducted this systematic review and meta-analysis of the primary outcomes of interest according to the PRISMA and AMSTAR Guidelines. Five databases were systematically searched, including Medline, PubMed, Cochrane Library, Scopus, and Web of Science. The search timeframe was set from database creation to February 2026. RESULTS: The…

Prognostic significance of pretreatment hydronephrosis in radiotherapy-based bladder-preserving strategies for muscle-invasive bladder cancer: a systematic review and meta-analysis.

Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica · 2026 · PMID 42212459

INTRODUCTION & OBJECTIVES: Radiotherapybased bladder-preserving strategies are established alternatives to radical cystectomy for selected patients with muscle-invasive bladder cancer (MIBC), yet survival outcomes remain heterogeneous and prognostic stratification is imprecise. Pretreatment hydronephrosis has shown adverse prognostic associations in cystectomy and trimodality therapy cohorts, but its impact across the broader spectrum of radiotherapy-based bladder preservation is unclear. This systematic review and…

Comparative efficacy of hyperthermic chemotherapy and BCG instillation in non-muscle invasive bladder cancer: a systematic review and meta-analysis.

International urology and nephrology · 2026 · PMID 41520313

OBJECTIVE: To systematically evaluate the comparative efficacy and safety of hyperthermic intravesical chemotherapy (HIVEC) versus bacillus Calmette-Guérin (BCG) instillation in patients with non-muscle-invasive bladder cancer (NMIBC). METHODS: A systematic literature search was conducted across PubMed, Embase, the Cochrane Library, and CBM from inception to June 30, 2025, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The study protocol was registered in the I…

Diagnostic performance of urinary tumor DNA in urothelial carcinoma: A systematic review and network meta-analysis.

Urologic oncology · 2026 · PMID 42184714

Accurate, non-invasive detection of urothelial carcinoma (UC) remains an unmet clinical need. Urinary tumor DNA (utDNA) assays have recently emerged as promising tools, but their comparative diagnostic performance across assay types remains uncertain. We conducted a systematic review and network meta-analysis in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) 2020 statement. PubMed, Cochrane Library, Web of Science, Google Scholar, and Clinical Trials.gov were searche…

Time-of-Day Immunotherapy Administration and Outcomes in Advanced Cancers: A Systematic Review and Meta-Analysis.

JAMA network open · 2026 · PMID 42084869

IMPORTANCE: Circadian rhythms affect immunity, which could affect the effectiveness of immune checkpoint inhibitor (ICI). Whether the time of ICI administration is associated with clinical outcomes in advanced cancers remains unclear. OBJECTIVE: To evaluate the association between time of day of ICI administration and oncologic outcomes in patients with advanced solid tumors. DATA SOURCES: MEDLINE (via PubMed), Embase, and Web of Science Core Collection were searched in February 2026 to identify eligible studies. S…

Perioperative Immunotherapy in Muscle-Invasive Bladder Cancer: A Systematic Review and Meta-Analysis of Neoadjuvant and Adjuvant Strategies.

Clinical oncology (Royal College of Radiologists (Great Britain)) · 2026 · PMID 42520756

AIMS: To evaluate the efficacy and safety of the perioperative immunotherapy-based regimens. MATERIALS AND METHODS: A systematic search of PubMed/MEDLINE, Embase, Scopus, and the Cochrane Central Register of Controlled Trials was performed from January 2000 to October 2025, with an updated search through June 2026. Eligible studies included randomized trials and prospective clinical studies evaluating neoadjuvant, adjuvant, or combined perioperative immunotherapy-based strategies in patients with MIBC. Outcomes inc…

Antibody-Drug Conjugates for Locally Advanced and Metastatic Urothelial Carcinoma: A Systematic Review and Meta-Analysis.

JAMA network open · 2026 · PMID 42223943

IMPORTANCE: Antibody-drug conjugates (ADCs), including enfortumab vedotin, disitamab vedotin, and sacituzumab govitecan, are altering the therapeutic landscape for locally advanced or metastatic urothelial carcinoma (la/mUC). Comprehensive comparative evidence evaluating their translation in the clinical setting and modifying clinical covariates is required. OBJECTIVE: To synthesize multidimensional evidence from interventional and observational settings to evaluate clinical outcomes, define the evolving therapeuti…

The Prognostic Value of Tumor HER2 Expression in Predicting Oncological Outcomes of Patients with Advanced Urothelial Carcinoma: A Systematic Review and Meta-Analysis.

International journal of molecular sciences · 2026 · PMID 42123709

The biologic and prognostic value of tumor human epidermal growth factor receptor 2 (HER2) expression in patients with advanced urothelial carcinoma (UC) who undergo systemic therapies remains controversial. A systematic search of English-language literature using PubMed, Scopus, and Cochrane Library was performed in October 2025 according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) protocol to evaluate the prognostic value of tumor HER2 expression in predicting oncological ou…

Blue versus white light for transurethral resection of non-muscle invasive bladder cancer.

The Cochrane database of systematic reviews · 2026 · PMID 42274003

RATIONALE: Disease recurrence and progression remain major challenges in the treatment of non-muscle invasive bladder cancer (NMIBC). Blue light-enhanced transurethral resection of bladder cancer (TURBT) is an approach to improve staging and achieve a complete resection of NMIBC. Since the first version of this review was published in 2021, new evidence on this topic has become available. OBJECTIVES: To assess the effects of blue light-enhanced TURBT compared to white light-based TURBT in the treatment of non-muscl…

FGFR3 Alterations and Nectin-4 Expression as Therapeutic Biomarkers in Bladder Cancer: A Systematic Review and Single-Arm Meta-Analysis.

International journal of molecular sciences · 2026 · PMID 42278538

Bladder cancer is a molecularly heterogeneous malignancy in which biomarker-driven therapies increasingly shape clinical management. Fibroblast growth factor receptor 3 (FGFR3) alterations and nectin-4 expression are key therapeutic targets, yet their integrated biological and clinical relevance remains unclear. A systematic search of PubMed, Scopus, and Cochrane Central was conducted from database inception to 22 February 2026 (PROSPERO: CRD420261309413). Studies reporting the prevalence of FGFR3 alterations and/o…

Stage-specific associations of HER2 overexpression with clinical and pathological features in bladder cancer: a systematic review and meta-analysis.

International urology and nephrology · 2026 · PMID 41876828

BACKGROUND: Human epidermal growth factor receptor 2 (HER2) overexpression is an established oncogenic driver and therapeutic target in several malignancies, but its clinical significance in urothelial carcinoma (UC) of the bladder remains controversial due to disease heterogeneity and lack of standardized assessment. OBJECTIVE: To synthesize evidence on the stage-specific associations of HER2 overexpression with clinicopathological features in bladder UC through a systematic review and meta-analysis. METHODS: We c…

Comparative efficacy and safety of carboplatin-based versus cisplatin-based chemotherapy in muscle-invasive and advanced bladder cancer: A systematic review and meta-analysis.

European journal of clinical pharmacology · 2026 · PMID 42271082

BACKGROUND: Cisplatin-based chemotherapy is the standard of care for muscle-invasive and advanced bladder cancer, but its significant toxicity renders approximately 30-50% of patient ineligible. Carboplatin is widely used as a substitute; however, its comparative efficacy and safety remain controversial due to fragmented and inconsistent evidence. This meta-analysis aims to compare survival outcomes, response rates, and toxicity profiles between carboplatin- and cisplatin-based regimens. METHODS: We conducted a sys…

Incidence and Spectrum of Adverse Events With Enfortumab Vedotin Therapy in Advanced or Metastatic Urothelial Carcinoma: Evidence From a Systematic Review and Meta-Analysis.

Archivos espanoles de urologia · 2026 · PMID 42438880

BACKGROUND: Systemic treatment options for locally advanced or metastatic urothelial carcinoma (La/mUC), especially for patients resistant to chemotherapy and ineligible for immunotherapy, are a current research focus. Enfortumab vedotin (EV), an antibody-drug conjugate targeting Nectin-4, has recently been introduced, necessitating attention to its potential adverse reactions for patient safety. METHODS: Databases were searched for publications up to 12 June 2025. Clinical trials and retrospective studies investig…

The predictive role of tertiary lymphoid structures in the prognosis and response to immunotherapy of bladder cancer patients: a systematic review and meta-analysis.

BMC cancer · 2026 · PMID 42288780

BACKGROUND: The association between tertiary lymphoid structures (TLS) and clinical outcomes in bladder cancer (BCa) patients, particularly their value in predicting immunotherapy response, remains inconsistent and has not been systematically evaluated. OBJECTIVE: This systematic review and meta-analysis aimed to: (1) evaluate the association between TLS and survival outcomes in BCa; (2) examine the relationship between TLS and clinicopathological characteristics; and (3) summarize evidence on TLS and immunotherapy…

Enfortumab vedotin monotherapy, enfortumab vedotin plus pembrolizumab, and immune checkpoint inhibitor-based neoadjuvant therapy for muscle-invasive bladder cancer: A systematic review and meta-analysis.

Urologic oncology · 2026 · PMID 42436099

Comparative efficacy among neoadjuvant enfortumab vedotin (EV) monotherapy, EV plus pembrolizumab (EV+P), and immune checkpoint inhibitor (ICI)-based regimens for muscle-invasive bladder cancer (MIBC) is unclear, and we aimed to compare pathological and survival outcomes among these strategies. We searched PubMed, Cochrane, Web of Science, Google Scholar, and ClinicalTrials.gov (January 2015-October 2025) for prospective Phase II or higher trials of ICI- or EV-containing neoadjuvant therapy reporting pathological c…

French AFU Cancer Committee Guidelines - Update 2024-2026: Muscle-invasive bladder cancer (MIBC).

The French journal of urology · 2024 · PMID 39581664

OBJECTIVE: To update the CCAFU recommendations for the management of muscle-invasive bladder cancer (MIBC). METHODS: A systematic review (Medline) of the literature from 2022 to 2024 was carried out, taking into account the elements of the diagnosis, the treatment options and the monitoring of NMIBC and MIBC, evaluating the references with their level of evidence. RESULTS: MIBC is diagosed after the must complete tumor resection possible . CT-Urography coupled with chest CT scans are used to assess the extent of MI…

SEOM-SOGUG clinical guideline for urothelial cancer (2025).

Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2025 · PMID 40960583

This clinical guideline provides evidence-based recommendations for the diagnosis, staging, and management of bladder cancer across all disease stages. In these guidelines (updated in 2025), we summarize current evidence and available therapies for the medical management of urothelial cancer.

Xpert bladder cancer detection and monitor in urothelial carcinoma: systematic review and meta-analysis.

Scientific reports · 2026 · PMID 42289472

Xpert Bladder Cancer (BC) is an mRNA-based urine assay for diagnosis and surveillance of urothelial carcinoma. Although previous meta-analyses have examined Xpert, none has evaluated its accuracy in both BC detection and non-muscle-invasive bladder cancer (NMIBC) surveillance, while also exploring its potential role in guiding repeat transurethral resection (re-TURBT) and in the diagnostic evaluation of upper tract urothelial carcinoma (UTUC). We systematically assessed the diagnostic accuracy of Xpert in all these…

French AFU Cancer Committee Guidelines - Update 2022-2024: Muscle-Invasive Bladder Cancer (MIBC).

Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie · 2022 · PMID 36400480

OBJECTIVE: To update the CCAFU recommendations for the management of muscle invasive bladder carcinoma (MIBC). METHODS: A systematic review (Medline) of the literature from 2020 to 2022 was performed taking account of the diagnosis, treatment options and surveillance of NMIBC and MIBC, while evaluating the references with their levels of evidence. RESULTS: MIBC is diagnosed after the most complete tumour resection possible. MIBC grading is based on CTU along with chest CT. Multiparametric pelvic MRI could be an alt…

Enfortumab vedotin-related skin toxicities in patients with urothelial carcinoma: A systematic review and meta-analysis.

Urologic oncology · 2025 · PMID 40592676

BACKGROUND: Enfortumab vedotin (EV) is an antibody-drug conjugate that binds nectin-4, a cell-adhesion molecule highly expressed in urothelial carcinoma (UC) and epidermal keratinocytes. Dermatologic events have become important EV-related toxicities in clinical trials and observational studies. We conducted a systematic review and meta-analysis on dermatological toxicity in UC patients treated with EV. METHODS: We systematically searched PubMed, Cochrane, and Embase for clinical trials (CT) and observational studi…

Associations between tertiary lymphoid structure density and immune checkpoint inhibitor efficacy in solid tumors: systematic review and meta-analysis.

Frontiers in immunology · 2024 · PMID 39544934

BACKGROUND: Tertiary lymphoid structures (TLS) play a crucial role in tumor immunity, yet their relationship with the efficacy of immune checkpoint inhibitors (ICI) in cancer therapy is not fully understood. This study aims to systematically evaluate how TLS density influences treatment outcomes in cancer patients receiving ICI therapy. METHODS: The PubMed, Embase, Cochrane Library, and Web of Science databases were searched for eligible studies published before January 22, 2024. Our analysis encompassed odds ratio…

Prognostic significance of circulating tumor DNA in urothelial carcinoma: a systematic review and meta-analysis.

International journal of surgery (London, England) · 2024 · PMID 38573063

BACKGROUND: Circulating tumor DNA (ctDNA) has emerged as a noninvasive technique that provides valuable insights into molecular profiles and tumor disease management. This study aimed to evaluate the prognostic significance of circulating tumor DNA (ctDNA) in urothelial carcinoma (UC) through a systematic review and meta-analysis. METHODS: A comprehensive search was conducted in MEDLINE, EMBASE, and the Cochrane Library from the inception to December 2023. Studies investigating the prognostic value of ctDNA in UC w…

Surveillance of non-muscle-invasive bladder cancer with blue-light cystoscopy: a meta-analysis.

BJU international · 2024 · PMID 38658172

OBJECTIVE: To compare the value of flexible blue-light cystoscopy (BLC) vs flexible white-light cystoscopy (WLC) in the surveillance setting of non-muscle-invasive bladder cancer (NMIBC). METHODS: All major databases were searched for articles published before May 2023 according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The primary outcome was the accuracy of flexible BLC vs WLC in detecting bladder cancer recurrence among suspicious bladder lesions. RESULTS: A to…

Diagnostic Test Accuracy of Urinary DNA Methylation-based Biomarkers for the Detection of Primary and Recurrent Bladder Cancer: A Systematic Review and Meta-analysis.

European urology focus · 2024 · PMID 38897871

BACKGROUND AND OBJECTIVE: Diagnosis of primary and relapsed bladder carcinomas is accomplished by urethrocystoscopy, an invasive procedure, combined with urinary cytology, with limited sensitivity, resulting in a substantial burden. Thus, noninvasive biomarkers have been investigated, among which DNA methylation has shown promise. This systematic review and meta-analysis sought to assess the diagnostic accuracy of DNA methylation biomarkers reported in the literature for bladder cancer detection, pinpointing the mo…

ctDNA-guided or ctDNA-stratified adjuvant immunotherapy compared with observation or placebo after radical surgery for muscle-invasive urothelial carcinoma: a GRADE-assessed systematic review and meta-analysis.

World journal of urology · 2026 · PMID 42661024

BACKGROUND: Adjuvant immunotherapy after radical surgery for muscle-invasive urothelial carcinoma has produced heterogeneous trial-level results, partly because clinicopathological risk factors do not completely identify patients with molecular residual disease (MRD). Circulating tumor DNA may refine postoperative treatment selection by distinguishing patients who are most likely to benefit from immune checkpoint inhibition from those who may experience unnecessary toxicity. METHODS: This systematic review and meta…

A Systematic Review of Intracavitary Therapies for Upper Tract Urothelial Carcinoma.

European urology oncology · 2026 · PMID 41241654

BACKGROUND AND OBJECTIVE: Radical nephroureterectomy is the standard of care for management of upper tract urothelial carcinoma (UTUC), but treatment-associated morbidity is not uncommon. Intracavitary therapy has emerged as a less invasive alternative for selected cases, particularly carcinoma in situ (CIS) and low-grade papillary tumors. We conducted a systematic review to evaluate the outcomes, recurrence rates, and adverse events associated with intracavitary therapy (immunotherapy or chemoablation) for UTUC. M…

Diagnostic Accuracy of Novel Urinary Biomarker Tests in Non-muscle-invasive Bladder Cancer: A Systematic Review and Network Meta-analysis.

European urology oncology · 2021 · PMID 34753702

CONTEXT: During the past decade, several urinary biomarker tests (UBTs) for bladder cancer have been developed and made commercially available. However, none of these is recommended by international guidelines so far. OBJECTIVE: To assess the diagnostic estimates of novel commercially available UBTs for diagnosis and surveillance of non-muscle-invasive bladder cancer (NMIBC) using diagnostic test accuracy (DTA) and network meta-analysis (NMA). EVIDENCE ACQUISITION: PubMed, Web of Science, and Scopus were searched u…

Increasing Biomarker Guidance in the Treatment of Urothelial Carcinoma: Systematic Review of International Clinical Trials.

Urologia internationalis · 2023 · PMID 36630942

PURPOSE: Precision oncology requires biomarker testing from tumor tissue for clinical decision-making and selection of targeted therapies. We systematically evaluated the role of tissue biomarker testing within interventional clinical trials for locally advanced and metastatic urothelial carcinoma (UC). METHODS: A systematic search within the publicly available ClinicalTrials.gov database was performed for the period 1995 to January 2020. We searched for all interventional studies on systemic treatments for advance…

ESMO Clinical Practice Guideline interim update on first-line therapy in advanced urothelial carcinoma.

Annals of oncology : official journal of the European Society for Medical Oncology · 2024 · PMID 38490358

Association of viral infection with bladder cancer: A systematic review and meta-analysis.

Pathology, research and practice · 2024 · PMID 39504615

BACKGROUND: Bladder cancer (BC) is the tenth most common cancer with the highest mortality rate. Since the etiological role of viral infection in the development of BC is less known, the aim of the present study was to examine the pooled prevalence and possible relationship between viral infection and BC. METHODS: A systematic search of major online databases was conducted to investigate relevant studies. We estimated the pooled odds ratio (OR), 95 % confidence interval (CI), and heterogeneity for all studies by us…

A Systematic Review and Meta-analysis of Chemoablation for Non-muscle-invasive Bladder Cancer.

European urology focus · 2023 · PMID 36517409

CONTEXT: The ablative effect of intravesical therapy is known for decades. However, the clinical feasibility and efficacy of chemoablation for non-muscle-invasive bladder cancer (NMIBC) have not become accepted. OBJECTIVE: To assess the treatment outcomes of chemoablation for NMIBC and to compare its safety with that of the standard treatment, transurethral resection of bladder tumors (TURBT) followed by intravesical therapy. EVIDENCE ACQUISITION: Multiple databases were queried in July 2022 for studies investigati…

Palliative radiotherapy for bladder cancer: a systematic review and meta-analysis.

Acta oncologica (Stockholm, Sweden) · 2021 · PMID 33591843

BACKGROUND/PURPOSE: The optimal dose fractionation for palliative radiotherapy (RT) in patients with symptomatic advanced bladder cancer is unclear. This study aimed to determine if a higher dose of RT was associated with improved symptoms response rates. METHODS: We searched PubMed, Central and Embase for eligible studies published from 1990 to 2019. The primary outcomes were symptoms response rates for hematuria, dysuria and frequency. Secondary outcomes included treatment-related adverse events and quality of li…

Adjuvant Chemotherapy for Muscle-invasive Bladder Cancer: A Systematic Review and Meta-analysis of Individual Participant Data from Randomised Controlled Trials.

European urology · 2022 · PMID 34802798

CONTEXT: Our prior systematic review and meta-analysis of individual participant data (IPD) suggesting a benefit of adjuvant chemotherapy for muscle-invasive bladder cancer was limited by the number and size of included randomised trials. We have updated results to include additional trials, providing the most up-to-date and reliable evidence of the effects of this treatment. OBJECTIVE: To investigate the role of adjuvant cisplatin-based chemotherapy in the treatment of muscle-invasive bladder cancer. EVIDENCE ACQU…

Dairy Product Consumption and Bladder Cancer Risk: A Meta-Analysis.

Nutrition and cancer · 2020 · PMID 31295044

To explore the potential relationship between dairy product consumption and bladder cancer risk, we retrieved eligible studies published up to March 15, 2018, via online database search and manual review of the selected articles. Summary relative risk (RR) estimates were calculated using random-effects models based on high to low intake values. Inter-study heterogeneity was explored using stratified analyses of study design, geographic region, or whether studies adjusted for the confounders age, sex, body mass inde…

Deep learning approaches for predicting response to neoadjuvant chemotherapy in muscle invasive bladder cancer: A systematic review.

Urologic oncology · 2026 · PMID 42481282

Neoadjuvant chemotherapy (NAC) followed by radical cystectomy is the standard of care for muscle-invasive bladder cancer (MIBC), yet treatment response is highly variable and current clinical predictors are inadequate. Deep learning (DL) offers a data-driven approach for modeling complex medical data and may improve response prediction. The objective of this systematic review was to systematically evaluate the performance, methodological rigor, and clinical applicability of DL models for predicting treatment respon…

Pioglitazone and bladder cancer risk: a systematic review and meta-analysis.

Cancer medicine · 2018 · PMID 29476615

Current evidence about the association between pioglitazone and bladder cancer risk remains conflict. We aimed to assess the risk of bladder cancer associated with the use of pioglitazone and identify modifiers that affect the results. We systematically searched PubMed, Embase, and Cochrane Central Register of Controlled Trials from inception to 25 August 2016 for randomized controlled trials (RCTs) and observational studies that evaluated the association between pioglitazone and bladder cancer risk. Conventional a…

Neoadjuvant immunotherapy and chemoimmunotherapy for stage II-III muscle invasive bladder cancer.

Frontiers in immunology · 2022 · PMID 36059550

OBJECTIVE: Considering the striking evidence revealed by immunotherapy in advanced or metastatic bladder cancer, investigators have explored neoadjuvant immunotherapy and chemoimmunotherapy in muscle-invasive bladder cancer (MIBC). Currently, there have been a large number of studies reporting varied efficacy and safety of these approaches. Herein, we pooled the available evidence in terms of oncological outcomes (pathological complete response [pCR] and pathological partial response [pPR]) and safety outcomes (imm…

Systematic review and meta-analysis of narrow band imaging for non-muscle-invasive bladder cancer.

International journal of urology : official journal of the Japanese Urological Association · 2021 · PMID 34453459

To assess the effect of narrow band imaging-guided transurethral resection of bladder tumor compared with white light on recurrence rates in non-muscle-invasive bladder cancer. A systematic review of the literature from inception to November 2020 using Medline, EMBASE and CENTRAL was undertaken. Randomized controlled trials comparing transurethral resection of bladder tumor undertaken with narrow band imaging with those undertaken with white light that reported recurrence rates of at least 12 months were included i…

Systematic review and meta-analysis of radiation therapy for high-risk non-muscle invasive bladder cancer.

Urologic oncology · 2021 · PMID 33846085

INTRODUCTION: Radiation therapy (XRT) has been investigated as a possible treatment for high-risk non-muscle invasive bladder cancer (NMIBC) with the goal of bladder preservation, especially with the ongoing Bacillus Calmette-Guerin (BCG) shortage. Yet, little is known about the clinical efficacy and the quality of evidence supporting XRT for NMIBC. Herein, we performed a systematic review and meta-analysis to evaluate XRT in the treatment of patients with high-risk NMIBC. METHODS: Cochrane Central Register of Cont…

Application Value of Radiomics-Based Machine Learning for Preoperative Risk Stratification of Bladder Cancer: Systematic Review and Meta-Analysis.

Journal of medical Internet research · 2026 · PMID 42285048

BACKGROUND: Some researchers have explored the application of radiomics-based machine learning to detect preoperative muscle invasion, high-grade tumors, human epidermal growth factor receptor 2 expression, and other risk factors for bladder cancer. However, systematic evidence proving its effectiveness remains lacking. OBJECTIVE: This study aimed to evaluate the performance of radiomics-based machine learning in preoperative risk stratification for patients with bladder cancer. These findings could contribute to a…

Consensus-Based Development of a Surgical Checklist for Transurethral Resection of Bladder Tumor: An Initiative of the Japanese Society of Urologic Oncology.

International journal of urology : official journal of the Japanese Urological Association · 2026 · PMID 42477956

OBJECTIVE: This study aimed to develop a nationwide, consensus-based surgical checklist to standardize transurethral resection of bladder tumor procedures and documentation. METHODS: In 2025, the Japanese Society of Urologic Oncology convened a working group of 20 bladder cancer specialist urologists to develop a national surgical checklist for transurethral resection of bladder tumors. A 12-member steering committee reviewed available evidence and proposed 30 candidate items. Using a modified Delphi approach, all …

Enfortumab vedotin monotherapy, enfortumab vedotin plus pembrolizumab, and immune checkpoint inhibitor-based neoadjuvant therapy for muscle-invasive bladder cancer: A systematic review and meta-analysis.

Urologic oncology · 2026 · PMID 42436099

Comparative efficacy among neoadjuvant enfortumab vedotin (EV) monotherapy, EV plus pembrolizumab (EV+P), and immune checkpoint inhibitor (ICI)-based regimens for muscle-invasive bladder cancer (MIBC) is unclear, and we aimed to compare pathological and survival outcomes among these strategies. We searched PubMed, Cochrane, Web of Science, Google Scholar, and ClinicalTrials.gov (January 2015-October 2025) for prospective Phase II or higher trials of ICI- or EV-containing neoadjuvant therapy reporting pathological c…

SEOM-SOGUG clinical guideline for urothelial cancer (2025).

Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2025 · PMID 40960583

This clinical guideline provides evidence-based recommendations for the diagnosis, staging, and management of bladder cancer across all disease stages. In these guidelines (updated in 2025), we summarize current evidence and available therapies for the medical management of urothelial cancer.

Prognostic significance of pretreatment hydronephrosis in radiotherapy-based bladder-preserving strategies for muscle-invasive bladder cancer: a systematic review and meta-analysis.

Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica · 2026 · PMID 42212459

INTRODUCTION & OBJECTIVES: Radiotherapybased bladder-preserving strategies are established alternatives to radical cystectomy for selected patients with muscle-invasive bladder cancer (MIBC), yet survival outcomes remain heterogeneous and prognostic stratification is imprecise. Pretreatment hydronephrosis has shown adverse prognostic associations in cystectomy and trimodality therapy cohorts, but its impact across the broader spectrum of radiotherapy-based bladder preservation is unclear. This systematic review and…

Intra-corporeal robot-assisted versus open radical cystectomy: a meta-analysis.

World journal of urology · 2026 · PMID 42525253

OBJECTIVE: To compare the safety and effectiveness between robot-assisted radical cystectomy with intracorporeal urinary diversion (iRARC) and open radical cystectomy (ORC). METHODS: We conducted this systematic review and meta-analysis of the primary outcomes of interest according to the PRISMA and AMSTAR Guidelines. Five databases were systematically searched, including Medline, PubMed, Cochrane Library, Scopus, and Web of Science. The search timeframe was set from database creation to February 2026. RESULTS: The…

Comparative efficacy of hyperthermic chemotherapy and BCG instillation in non-muscle invasive bladder cancer: a systematic review and meta-analysis.

International urology and nephrology · 2026 · PMID 41520313

OBJECTIVE: To systematically evaluate the comparative efficacy and safety of hyperthermic intravesical chemotherapy (HIVEC) versus bacillus Calmette-Guérin (BCG) instillation in patients with non-muscle-invasive bladder cancer (NMIBC). METHODS: A systematic literature search was conducted across PubMed, Embase, the Cochrane Library, and CBM from inception to June 30, 2025, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The study protocol was registered in the I…

Time-of-Day Immunotherapy Administration and Outcomes in Advanced Cancers: A Systematic Review and Meta-Analysis.

JAMA network open · 2026 · PMID 42084869

IMPORTANCE: Circadian rhythms affect immunity, which could affect the effectiveness of immune checkpoint inhibitor (ICI). Whether the time of ICI administration is associated with clinical outcomes in advanced cancers remains unclear. OBJECTIVE: To evaluate the association between time of day of ICI administration and oncologic outcomes in patients with advanced solid tumors. DATA SOURCES: MEDLINE (via PubMed), Embase, and Web of Science Core Collection were searched in February 2026 to identify eligible studies. S…

Perioperative Immunotherapy in Muscle-Invasive Bladder Cancer: A Systematic Review and Meta-Analysis of Neoadjuvant and Adjuvant Strategies.

Clinical oncology (Royal College of Radiologists (Great Britain)) · 2026 · PMID 42520756

AIMS: To evaluate the efficacy and safety of the perioperative immunotherapy-based regimens. MATERIALS AND METHODS: A systematic search of PubMed/MEDLINE, Embase, Scopus, and the Cochrane Central Register of Controlled Trials was performed from January 2000 to October 2025, with an updated search through June 2026. Eligible studies included randomized trials and prospective clinical studies evaluating neoadjuvant, adjuvant, or combined perioperative immunotherapy-based strategies in patients with MIBC. Outcomes inc…

Stage-specific associations of HER2 overexpression with clinical and pathological features in bladder cancer: a systematic review and meta-analysis.

International urology and nephrology · 2026 · PMID 41876828

BACKGROUND: Human epidermal growth factor receptor 2 (HER2) overexpression is an established oncogenic driver and therapeutic target in several malignancies, but its clinical significance in urothelial carcinoma (UC) of the bladder remains controversial due to disease heterogeneity and lack of standardized assessment. OBJECTIVE: To synthesize evidence on the stage-specific associations of HER2 overexpression with clinicopathological features in bladder UC through a systematic review and meta-analysis. METHODS: We c…

Associations between tertiary lymphoid structure density and immune checkpoint inhibitor efficacy in solid tumors: systematic review and meta-analysis.

Frontiers in immunology · 2024 · PMID 39544934

BACKGROUND: Tertiary lymphoid structures (TLS) play a crucial role in tumor immunity, yet their relationship with the efficacy of immune checkpoint inhibitors (ICI) in cancer therapy is not fully understood. This study aims to systematically evaluate how TLS density influences treatment outcomes in cancer patients receiving ICI therapy. METHODS: The PubMed, Embase, Cochrane Library, and Web of Science databases were searched for eligible studies published before January 22, 2024. Our analysis encompassed odds ratio…

The predictive role of tertiary lymphoid structures in the prognosis and response to immunotherapy of bladder cancer patients: a systematic review and meta-analysis.

BMC cancer · 2026 · PMID 42288780

BACKGROUND: The association between tertiary lymphoid structures (TLS) and clinical outcomes in bladder cancer (BCa) patients, particularly their value in predicting immunotherapy response, remains inconsistent and has not been systematically evaluated. OBJECTIVE: This systematic review and meta-analysis aimed to: (1) evaluate the association between TLS and survival outcomes in BCa; (2) examine the relationship between TLS and clinicopathological characteristics; and (3) summarize evidence on TLS and immunotherapy…

Prognostic role of preoperative plasma fibrinogen-to-albumin ratio in urological carcinomas: a systematic review and meta-analysis.

BMC urology · 2026 · PMID 42310688

BACKGROUND: Growing evidence indicates that the pre-operative ratio of fibrinogen to albumin (FAR/AFR) can act as a prognostic predictor for different kinds of cancer. Although a previous meta-analysis briefly involved urological malignancies, it only incorporated one study for bladder cancer (BC) and one for renal cell carcinoma (RCC) with limited data. To date, a comprehensive and systematic quantitative assessment of plasma FAR/AFR as a prognostic indicator in urological cancers remains lacking. OBJECTIVE: This …

Clinical complete response as a surrogate for pathological response in bladder cancer: a systematic review and meta-analysis.

BJU international · 2026 · PMID 41839747

OBJECTIVE: To evaluate the concordance between clinical complete response (cCR) and pathological complete response (pCR) in muscle-invasive bladder cancer (MIBC) to assess the surrogacy and prognostic value of cCR for guiding bladder-sparing strategies. METHODS: In this prospectively registered systematic review and meta-analysis (CRD420251066540), we searched MEDLINE, EMBASE, and Web of Science in June 2025 for studies reporting clinical and pathological complete response rates in patients with MIBC undergoing neo…

Efficacy and safety of combination versus single-agent immunotherapy for BCG-unresponsive non-muscle-invasive bladder cancer.

Frontiers in immunology · 2026 · PMID 42582256

BACKGROUND: Bacillus Calmette-Guérin (BCG) is the standard adjuvant therapy for high-risk non-muscle-invasive bladder cancer (NMIBC); however, a substantial proportion of patients develop BCG-unresponsive disease with limited bladder-preserving options. The objective of this study was to determine whether combination immunotherapy provides superior clinical efficacy and safety compared with single-agent immunotherapy for patients with BCG-unresponsive NMIBC. METHODS: We conducted a systematic analysis of studies re…

ctDNA-guided or ctDNA-stratified adjuvant immunotherapy compared with observation or placebo after radical surgery for muscle-invasive urothelial carcinoma: a GRADE-assessed systematic review and meta-analysis.

World journal of urology · 2026 · PMID 42661024

BACKGROUND: Adjuvant immunotherapy after radical surgery for muscle-invasive urothelial carcinoma has produced heterogeneous trial-level results, partly because clinicopathological risk factors do not completely identify patients with molecular residual disease (MRD). Circulating tumor DNA may refine postoperative treatment selection by distinguishing patients who are most likely to benefit from immune checkpoint inhibition from those who may experience unnecessary toxicity. METHODS: This systematic review and meta…

Hand-sewn versus stapled ileo-ileal anastomosis following radical cystectomy: A systematic review and meta-analysis.

Urologic oncology · 2026 · PMID 42134079

Radical cystectomy (RC) with urinary diversion is the standard treatment for muscle-invasive bladder cancer. Intestinal continuity may be restored using either hand-sewn or stapled ileo-ileal anastomosis, yet contemporary evidence comparing their clinical and economic outcomes is limited. This study aims to evaluate and compare perioperative outcomes, postoperative complications, and hospital parameters between these 2 techniques. PubMed, Scopus, Web of Science, and Cochrane Library were searched for studies publis…

A Systematic Review of Intracavitary Therapies for Upper Tract Urothelial Carcinoma.

European urology oncology · 2026 · PMID 41241654

BACKGROUND AND OBJECTIVE: Radical nephroureterectomy is the standard of care for management of upper tract urothelial carcinoma (UTUC), but treatment-associated morbidity is not uncommon. Intracavitary therapy has emerged as a less invasive alternative for selected cases, particularly carcinoma in situ (CIS) and low-grade papillary tumors. We conducted a systematic review to evaluate the outcomes, recurrence rates, and adverse events associated with intracavitary therapy (immunotherapy or chemoablation) for UTUC. M…

Long-term complications in patients with bladder-prostate rhabdomyosarcoma treated with brachytherapy: a systematic review.

Pediatric surgery international · 2025 · PMID 40924160

INTRODUCTION: Brachytherapy has been used for the multimodal treatment of pediatric bladder-prostate rhabdomyosarcoma in the last two decades. The aim of this systematic review is to gather the current evidence about this innovative technique with a special focus on long-term outcomes. METHODS: According to PRISMA criteria, PubMed, Scopus, and Web of Science were searched for papers published between 2000 and 2022. RESULTS: The search yielded 7338 papers but only seven were eligible, for a total of 196 children wit…

Sexual life and intimate relationship experience among bladder cancer patients: a systematic review and qualitative meta-synthesis.

Frontiers in public health · 2026 · PMID 42688463

OBJECTIVES: The global incidence of bladder cancer continues to rise. Treatments for this disease, particularly radical cystectomy and urinary diversion, can profoundly disrupt sexual function and intimate relationships, leading to physiological, psychological, relational, and existential changes. However, qualitative evidence syntheses that integrate these experiences remain limited. This review aimed to synthesize qualitative research on bladder cancer patients' sexual life and intimate relationship experiences i…

Deep learning approaches for predicting response to neoadjuvant chemotherapy in muscle invasive bladder cancer: A systematic review.

Urologic oncology · 2026 · PMID 42481282

Neoadjuvant chemotherapy (NAC) followed by radical cystectomy is the standard of care for muscle-invasive bladder cancer (MIBC), yet treatment response is highly variable and current clinical predictors are inadequate. Deep learning (DL) offers a data-driven approach for modeling complex medical data and may improve response prediction. The objective of this systematic review was to systematically evaluate the performance, methodological rigor, and clinical applicability of DL models for predicting treatment respon…

Comparative efficacy of perioperative systemic therapies for muscle-invasive bladder cancer: a network meta-analysis of randomized trials.

ESMO open · 2026 · PMID 42485700

BACKGROUND: The perioperative treatment landscape of muscle-invasive bladder cancer (MIBC) is rapidly evolving with the introduction of immune checkpoint inhibitor (ICI)- and antibody-drug conjugate (ADC)-based strategies. However, direct randomized comparisons among contemporary regimens are lacking, limiting the interpretation and positioning of treatments. We aimed to compare the efficacy of perioperative systemic treatment strategies for MIBC with a network meta-analysis (NMA) of randomized controlled trials (R…

Adjuvant PD-1 Inhibitors After Radical Surgery for High-Risk Muscle-Invasive Urothelial Carcinoma: A Systematic Review and Meta-Analysis of Phase 3 Trials.

Urology practice · 2026 · PMID 41665515

INTRODUCTION: Patients with high-risk muscle-invasive bladder cancer (MIBC) remain at substantial risk of disease recurrence. Randomized phase 3 trials have evaluated adjuvant programmed cell death 1 (PD-1) inhibitors in this setting, but the magnitude and consistency of benefit across patient subgroups remain incompletely defined. METHODS: We performed a systematic review and meta-analysis of randomized phase 3 trials comparing adjuvant PD-1 inhibitors with placebo or observation in patients with resected high-ris…

Tranexamic acid in radical cystectomy: a systematic review and meta-analysis of efficacy and safety.

World journal of urology · 2025 · PMID 40965659

PURPOSE: Radical cystectomy (RC) is a high-risk procedure, associated with significant bleeding and high risk of perioperative blood transfusion (PBT), which may limit clinical and oncological outcomes. Tranexamic acid (TXA), an antifibrinolytic agent, effectively reduces bleeding in various surgical settings; however, its role in RC remains understudied. This systematic review and meta-analysis evaluates the efficacy and safety of TXA in RC patients. METHODS: A systematic search of CENTRAL, PubMed, Embase, and Web…

A systematic review and meta-analysis of clinicopathologic factors associated with adverse oncologic outcomes in bladder cancer patients undergoing radical cystectomy: Evidence from multivariable survival prediction models.

Urologic oncology · 2026 · PMID 42086443

This systematic review aimed to identify robust clinicopathologic predictors of overall (OS), cancer-specific (CSS), and recurrence-free survival (RFS) following radical cystectomy (RC) from published prediction models. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and TRIPOD (Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis) recommendations were followed, and the study was registered in PROSPERO (CRD42024509410). MEDLINE (Ovid) and Embase…

Prognostic value of preoperative systemic immune-inflammation index in patients with bladder cancer undergoing radical cystectomy: a systematic review and meta-analysis.

Frontiers in oncology · 2026 · PMID 42666146

BACKGROUND: To improve risk stratification in patients with bladder cancer (BC) undergoing radical cystectomy (RC), the systemic immune-inflammation index (SII), calculated from routine blood parameters, has attracted attention as a promising prognostic biomarker. This meta-analysis aims to synthesize existing evidence regarding the prognostic utility of SII and to elucidate its potential clinical significance. METHODS: This systematic review and meta-analysis, conducted in accordance with the PRISMA framework, inc…

SEOM-SOGUG clinical guideline for urothelial cancer (2025).

Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2025 · PMID 40960583

This clinical guideline provides evidence-based recommendations for the diagnosis, staging, and management of bladder cancer across all disease stages. In these guidelines (updated in 2025), we summarize current evidence and available therapies for the medical management of urothelial cancer.

Enfortumab vedotin monotherapy, enfortumab vedotin plus pembrolizumab, and immune checkpoint inhibitor-based neoadjuvant therapy for muscle-invasive bladder cancer: A systematic review and meta-analysis.

Urologic oncology · 2026 · PMID 42436099

Comparative efficacy among neoadjuvant enfortumab vedotin (EV) monotherapy, EV plus pembrolizumab (EV+P), and immune checkpoint inhibitor (ICI)-based regimens for muscle-invasive bladder cancer (MIBC) is unclear, and we aimed to compare pathological and survival outcomes among these strategies. We searched PubMed, Cochrane, Web of Science, Google Scholar, and ClinicalTrials.gov (January 2015-October 2025) for prospective Phase II or higher trials of ICI- or EV-containing neoadjuvant therapy reporting pathological c…

Xpert bladder cancer detection and monitor in urothelial carcinoma: systematic review and meta-analysis.

Scientific reports · 2026 · PMID 42289472

Xpert Bladder Cancer (BC) is an mRNA-based urine assay for diagnosis and surveillance of urothelial carcinoma. Although previous meta-analyses have examined Xpert, none has evaluated its accuracy in both BC detection and non-muscle-invasive bladder cancer (NMIBC) surveillance, while also exploring its potential role in guiding repeat transurethral resection (re-TURBT) and in the diagnostic evaluation of upper tract urothelial carcinoma (UTUC). We systematically assessed the diagnostic accuracy of Xpert in all these…

Associations between tertiary lymphoid structure density and immune checkpoint inhibitor efficacy in solid tumors: systematic review and meta-analysis.

Frontiers in immunology · 2024 · PMID 39544934

BACKGROUND: Tertiary lymphoid structures (TLS) play a crucial role in tumor immunity, yet their relationship with the efficacy of immune checkpoint inhibitors (ICI) in cancer therapy is not fully understood. This study aims to systematically evaluate how TLS density influences treatment outcomes in cancer patients receiving ICI therapy. METHODS: The PubMed, Embase, Cochrane Library, and Web of Science databases were searched for eligible studies published before January 22, 2024. Our analysis encompassed odds ratio…

ctDNA-guided or ctDNA-stratified adjuvant immunotherapy compared with observation or placebo after radical surgery for muscle-invasive urothelial carcinoma: a GRADE-assessed systematic review and meta-analysis.

World journal of urology · 2026 · PMID 42661024

BACKGROUND: Adjuvant immunotherapy after radical surgery for muscle-invasive urothelial carcinoma has produced heterogeneous trial-level results, partly because clinicopathological risk factors do not completely identify patients with molecular residual disease (MRD). Circulating tumor DNA may refine postoperative treatment selection by distinguishing patients who are most likely to benefit from immune checkpoint inhibition from those who may experience unnecessary toxicity. METHODS: This systematic review and meta…

A Systematic Review of Intracavitary Therapies for Upper Tract Urothelial Carcinoma.

European urology oncology · 2026 · PMID 41241654

BACKGROUND AND OBJECTIVE: Radical nephroureterectomy is the standard of care for management of upper tract urothelial carcinoma (UTUC), but treatment-associated morbidity is not uncommon. Intracavitary therapy has emerged as a less invasive alternative for selected cases, particularly carcinoma in situ (CIS) and low-grade papillary tumors. We conducted a systematic review to evaluate the outcomes, recurrence rates, and adverse events associated with intracavitary therapy (immunotherapy or chemoablation) for UTUC. M…

Role of Postoperative Radiation Therapy After Radical Cystectomy for Bladder Cancer: A Systematic Review and Meta-Analysis.

Advances in radiation oncology · 2026 · PMID 42382432

PURPOSE: Radical cystectomy with neoadjuvant cisplatin-based chemotherapy is the standard of care for muscle-invasive bladder cancer (MIBC). However, recurrence remains common. Postoperative radiation therapy (PORT) has been explored to improve locoregional control and survival, but evidence remains inconclusive. This systematic review and meta-analysis assessed the role of PORT in MIBC. METHODS AND MATERIALS: PubMed, Embase, and Cochrane were searched through March 2025 (CRD42025632052). Eligible studies included …

Extended Versus Non-Extended Lymphadenectomy in Radical Cystectomy for Bladder Cancer: A Systematic Review and Meta-Analysis.

Journal of surgical oncology · 2026 · PMID 42655992

Pelvic lymph node dissection is an essential component of radical cystectomy (RC) for bladder cancer (BC), but the optimal extent of lymphadenectomy remains uncertain. We conducted a systematic review and meta-analysis to compare oncologic and perioperative outcomes between extended and non-extended lymphadenectomy during RC for BC. PubMed/MEDLINE, Embase, and ClinicalTrials. gov were searched up to October 2025 following PRISMA guidelines and PROSPERO registration. Randomized controlled trials (RCTs) and observati…

Deep learning approaches for predicting response to neoadjuvant chemotherapy in muscle invasive bladder cancer: A systematic review.

Urologic oncology · 2026 · PMID 42481282

Neoadjuvant chemotherapy (NAC) followed by radical cystectomy is the standard of care for muscle-invasive bladder cancer (MIBC), yet treatment response is highly variable and current clinical predictors are inadequate. Deep learning (DL) offers a data-driven approach for modeling complex medical data and may improve response prediction. The objective of this systematic review was to systematically evaluate the performance, methodological rigor, and clinical applicability of DL models for predicting treatment respon…

Neoplasms in prune belly syndrome: A novel case of early-onset metastatic bladder carcinoma and systematic review of reported tumors.

Journal of pediatric urology · 2026 · PMID 42263627

PURPOSE: Prune Belly Syndrome (PBS) is a rare congenital malformation complex characterized by cryptorchidism, urinary tract abnormalities and deficiency of the abdominal wall musculature. Although advances in neonatal and reconstructive care have substantially improved survival, the long-term risk of malignancy in this population remains poorly defined. We report a novel case of early-onset metastatic bladder carcinoma in a patient with PBS and perform a systematic review of all tumors described in association wit…

Environmental Nonessential Element Exposure and Urologic Cancer: A Systematic Review and Meta-Analysis.

JAMA network open · 2026 · PMID 42172026

IMPORTANCE: Urologic cancers have been linked to nonessential chemical elements with no known beneficial role in the body, though associations between low-level environmental exposure and urologic cancer risk are poorly understood. OBJECTIVE: To systematically synthesize epidemiologic evidence on the association between environmental exposure to nonessential elements and risk of urologic cancers. DATA SOURCES: English- and Chinese-language databases, including PubMed, Embase, Web of Science, Scopus, Cumulated Index…

Indirect Comparison of Neoadjuvant Treatment Strategies for Muscle-Invasive Bladder Cancer: ddMVAC and Perioperative Durvalumab-Gemcitabine-Cisplatin Versus Gemcitabine-Cisplatin: A Systematic Review and Network Meta-Analysis of Randomised Controlled Trials.

International journal of cancer · 2026 · PMID 42050770

For cisplatin-eligible patients with muscle-invasive bladder cancer (MIBC) undergoing radical cystectomy (RC), neoadjuvant cisplatin-based chemotherapy (NAC) is standard of care. More intensive regimens such as dose-dense methotrexate, vinblastine, doxorubicin and cisplatin (ddMVAC) and chemoimmunotherapy with durvalumab plus gemcitabine-cisplatin (D-GC) have shown superior outcomes. This network meta-analysis (NMA) compares the efficacy of ddMVAC, D-GC and GC and explores the efficacy thresholds for emerging thera…

Health risk assessment of inorganic arsenic: an umbrella review.

Reviews on environmental health · 2026 · PMID 42494104

Inorganic arsenic (iAs) is a toxic environmental pollutant linked to serious health risks, prompting global regulatory efforts. This study identifies major health conditions associated with iAs exposure using text network analysis, and assesses health risk assessments through an umbrella review and dose-response analysis. It synthesizes previous systematic reviews to offer a broader perspective on iAs-related health effects. An optimized text network analysis-based search strategy was applied across multiple databa…

Antibiotic exposure and cancer risk: an umbrella review elucidating the direction of risk across 14 malignancies.

Journal of public health (Oxford, England) · 2026 · PMID 42361054

BACKGROUND: Antibiotics are among the most frequently prescribed medications worldwide. However, previous studies have yielded inconsistent findings regarding the association between antibiotic exposure and the risk of various cancers, and the credibility of the available evidence remains uncertain. METHODS: We conducted an umbrella review based on published meta-analyses and systematic reviews to evaluate the association between past or current antibiotic exposure and cancer risk. PubMed, Embase, Cochrane Library,…

Immune-Enhancing Nutrition and Outcomes After Radical Cystectomy: A Randomized Clinical Trial.

JAMA network open · 2026 · PMID 42475098

IMPORTANCE: Radical cystectomy for bladder cancer is associated with high complication rates. Evidence supporting perioperative specialized immunonutrition for reducing complications is limited. OBJECTIVE: To determine whether perioperative specialized immunonutrition reduces 30-day complications compared with standard oral nutrition support among adults undergoing radical cystectomy. DESIGN, SETTING, AND PARTICIPANTS: This multicenter, randomized, double-blind, phase 3 clinical trial (SWOG S1600) conducted at 13 U…

Prognostic Factors for Overall Survival in the VESPER Trial: Basal Molecular Subtype Is a Relevant Key Factor.

European urology oncology · 2026 · PMID 41577609

BACKGROUND AND OBJECTIVE: Our aim was to identify potential prognostic factors for overall survival (OS) for patients with muscle-invasive bladder cancer treated with neoadjuvant chemotherapy (NAC) and cystectomy in the VESPER trial (NCT01812369). METHODS: We focused on the NAC VESPER population (n = 437), including 218 patients who received dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin, and 219 who received gemcitabine and cisplatin. Tumor slides and formalin-fixed, paraffin-embedded blocks were…

Impact of Intravesical Bacillus Calmette-Guérin Therapy Following Transurethral En Bloc Resection of Bladder Tumour: Post Hoc Analysis of a Randomised, Multicentre, Phase 3 Trial.

European urology oncology · 2026 · PMID 41177716

We conducted a post hoc analysis of the EB-StaR study (NCT02993211) to assess the impact of intravesical bacillus Calmette-Guérin (BCG) therapy following en bloc resection of bladder tumour (ERBT) or standard resection (SR) in patients with non-muscle-invasive bladder cancer (NMIBC). The outcome measures were the 1-yr recurrence and progression rates. Among the 276 patients included in the analysis, 1-yr recurrence rates were 33% (95% confidence interval [CI] 21-43%) in the ERBT alone group versus 41% (95% CI 30-50…

DaBlaCa-13 Study: Five-year Follow-up from the Randomized Controlled Trial of Chemoresection with Intravesical Mitomycin C in Recurrent Ta Non-muscle-invasive Bladder Cancer.

European urology oncology · 2026 · PMID 41864769

BACKGROUND AND OBJECTIVE: Transurethral resection of bladder tumors (TURBT) remains the standard treatment for non-muscle-invasive bladder cancer (NMIBC) but is associated with procedural risks and health care burden. Chemoresection using intravesical mitomycin C (MMC) has emerged as a minimally invasive alternative. This randomized controlled trial presents 5-yr follow-up data evaluating long-term outcomes of MMC chemoresection versus standard surgical management in patients with intermediate-risk NMIBC. METHODS: …

Best evidence summary on gastrointestinal function recovery after radical cystectomy for bladder cancer.

Asia-Pacific journal of oncology nursing · 2026 · PMID 41541189

OBJECTIVE: To summarize the best available evidence on gastrointestinal function recovery in patients with bladder cancer undergoing radical cystectomy. METHODS: A systematic search was conducted following the Evidence-Based Health care Pyramid 5.0, covering major academic databases, professional society websites, and clinical decision support tools. Literature published up to March 31, 2025, was included. Two independent reviewers assessed the quality of included studies and extracted relevant evidence. RESULTS: N…

Time-varying prognostic value of circulating tumor DNA in urothelial carcinoma: a systematic review and reconstructed patient-data meta-analysis.

Critical reviews in oncology/hematology · 2026 · PMID 42679916

Circulating tumor DNA (ctDNA) increasingly guides adjuvant therapy and surveillance in urothelial carcinoma (UC), yet whether its prognostic effect is adequately summarized by a single pooled hazard ratio (HR), which assumes proportional hazards (PH), has not been formally evaluated. We searched five sources for studies reporting ctDNA prognostic associations across non-muscle-invasive, muscle-invasive (MIBC), upper-tract and metastatic UC. HRs for unfavorable versus favorable ctDNA were pooled by Bayesian random-e…

Intravesical mitomycin-C administered immediately before transurethral resection of bladder tumor in non-muscle-invasive bladder cancer: Clinical outcomes and molecular predictors from over 3 years of extended follow-up in a phase II trial.

Investigative and clinical urology · 2026 · PMID 42683856

PURPOSE: To evaluate the long-term outcomes and molecular correlates of response after immediate preoperative intravesical chemotherapy (IPeIC) with mitomycin-C (MMC) in patients with non-muscle-invasive bladder cancer (NMIBC). MATERIALS AND METHODS: In this single-center, open-label, randomized phase II trial, 33 patients received two split doses of IPeIC/MMC (40 mg/20 mL), whereas 38 patients underwent transurethral resection of bladder tumor (TURBT) alone. The primary endpoint was 3-year recurrence-free survival…

A phase Ib/II, open-label, multicenter, randomized umbrella study evaluating the combination of atezolizumab with sacituzumab govitecan in patients with locally advanced or metastatic urothelial carcinoma and previously treated with a platinum-based treatment regimen (MORPHEUS-Urothelial Carcinoma).

ESMO open · 2026 · PMID 42418909

BACKGROUND: MORPHEUS-UC (NCT03869190) is a signal-seeking, global, phase Ib/II, open-label, multicenter, randomized, umbrella study in patients with platinum-treated locally advanced or metastatic urothelial carcinoma (mUC). Patients were randomly assigned to one of seven atezolizumab (anti-programmed death-ligand 1)-based treatment combinations or atezolizumab monotherapy. We report efficacy and safety results for atezolizumab + sacituzumab govitecan (trophoblast cell surface antigen-2-directed antibody conjugate)…

Adjuvant chemotherapy vs. observation for locally advanced upper tract urothelial carcinoma following radical nephroureterectomy.

Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2026 · PMID 42678689

INTRODUCTION: Although a single randomized trial demonstrated improved survival with adjuvant chemotherapy (AC) for locally advanced (pT2-4 or N+) upper tract urothelial carcinoma (UTUC) after radical nephroureterectomy (RNU), this survival benefit was not observed in pT2 or N+ patients, and real-world data are lacking. We therefore emulated the completed POUT trial using a large, nationwide cancer registry. METHODS: We identified patients aged 50-79 years with pT2-4 or pN+, non-metastatic UTUC treated with RNU fro…

Robotic-assisted intracorporeal radical cystectomy with modified ileal conduit reduces ureteroileal anastomotic stenosis risk: a comparative study with laparoscopic surgery.

Annals of medicine · 2026 · PMID 42525819

BACKGROUND: This study aims to evaluate the clinical efficacy of an innovative robot-assisted totally intracorporeal antecolic modified ileal conduit procedure (robotic group) versus laparoscopic surgery (laparoscopic group) in bladder cancer patients, providing evidence for optimizing urinary diversion strategies and reducing associated complications. METHODS: From Jan 2023 to Oct 2025, 69 patients undergoing total cystectomy by one surgeon were enrolled; 23 received robotic surgery (KangDuo SR2000) and 46 laparos…

Combination treatment with intravesical interferon-alpha gene therapy and an oral pan-ErbB receptor family blocker improves survival in mice with bladder cancer.

Frontiers in molecular biosciences · 2026 · PMID 42638663

INTRODUCTION: Intravesical interferon-alpha (IFNα) gene therapy is approved by the FDA for BCG-unresponsive non-muscle invasive bladder cancer (NMIBC). Identifying resistance mechanisms and deploying targeted combination treatment strategies is a rational approach to improving treatment responses. We identified the ErbB pathway as a resistance mechanism to IFNα gene therapy, and we hypothesized that combination treatment with an ErbB pathway blocker and IFN-α could improve outcomes in resistant tumors. METHODS: Mur…

Proteomic Signatures of Vemurafenib Resistance in Canine Urothelial Carcinoma Harboring the BRAFV595E Mutation.

Journal of proteome research · 2026 · PMID 42359562

Naturally occurring canine invasive urothelial carcinoma (InvUC) often harbors a BRAFV595E mutation, analogous to human BRAFV600E found across multiple cancer types, and has been used to investigate the effects of BRAF-targeted therapy. To investigate proteomic and phosphoproteomic changes during therapy, we analyzed 42 samples from 14 dogs with BRAFV595E-positive InvUC treated with vemurafenib. Tumors were collected via cystoscopy before treatment (Pre-Vem), 1 month into treatment (Vem-1-month), and at the time of…

Leverage of quick-soluble gelatin microparticles in transarterial chemoembolization of canine urothelial carcinomas.

The veterinary quarterly · 2026 · PMID 42216429

Lower urinary tract carcinomas in dogs are rare conditions with a poor prognosis. This prospective clinical study evaluated the safety, feasibility, and therapeutic efficacy of transarterial chemoembolization (TACE) using quick-soluble gelatin microparticles (QS-GMP) in 29 client-owned dogs with lower urinary tract carcinomas. Tumors primarily involved the bladder and urethra. Following selective catheterization of tumor-feeding vessels, intra-arterial carboplatin was administered prior to QS-GMP embolization. All …

ATR inhibitors synergise with mitomycin C to enhance cytotoxicity in patient-derived non-muscle invasive bladder cancer organoids.

British journal of cancer · 2026 · PMID 42675137

BACKGROUND: There is a high recurrence rate in non-muscle invasive bladder cancer (NMIBC) patients treated with intravesical chemotherapy or BCG, indicating the need for novel treatment options. Synergy between DNA damage response inhibitors and chemotherapy has been shown for different solid tumours. Here, we explore whether combining chemotherapeutic agents with Ataxia telangiectasia and Rad3-related (ATR) kinase inhibitors is a suitable strategy to reduce recurrence in NMIBC. METHODS: NMIBC patient-derived organ…

Heat-activated intravenous liposomal doxorubicin combined with mitomycin C hyperthermic intravesical chemotherapy (HIVEC) for treatment of bladder cancer.

International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group · 2026 · PMID 41631502

PURPOSE: To evaluate the safety and pharmacokinetics of lyso-thermosensitive liposomal doxorubicin (LTLD, ThermoDox®) combined with mitomycin C (MMC) hyperthermic intravesical chemotherapy (HIVEC) as a potential treatment for non-muscle invasive bladder cancer. MATERIALS AND METHODS: Four healthy swine received a 30-minute intravenous infusion of LTLD in combination with HIVEC, consisting of one hour of warm MMC bladder recirculation. Full-thickness bladder wall specimens were surgically resected within 30 min of H…

Histologic and immunohistochemical characterization and frequency of rare subtypes of canine invasive urothelial carcinoma.

Veterinary pathology · 2026 · PMID 41879030

While most cases of human muscle-invasive bladder cancer (MIBC) are diagnosed as conventional urothelial carcinoma (UC), there is growing recognition of histologic subtypes and divergent differentiation within conventional UC. In this study, 31 dogs with UC (33 slides) were evaluated for histologic subtypes and divergent differentiation, as specified by the recent World Health Organization update on the classification of urinary bladder cancers. Slides were reviewed by a medical uropathologist and 3 board-certified…

Localized in-situ nanomedicine synthesis enables copper-mediated cuproptosis for effective bladder cancer therapy.

European journal of pharmaceutical sciences : official journal of the European Federation for Pharmaceutical Sciences · 2026 · PMID 42468858

Nanomedicine based approaches offer new prospects for cancer treatment by enabling localized delivery, improved tissue retention, and microenvironment response therapeutic activation. Bladder cancer remains challenging due to high recurrence rate and the limited effectiveness of conventional intravesical therapies largely resulting from insufficient tissue penetration and short drug residence time, especially under fluid washouts (urination). This study aims to develop a locally administered nanomedicine platform t…

Beyond translation: systematic insight of the multifaceted roles of GARS1 in cellular biology and disease.

Cell cycle (Georgetown, Tex.) · 2026 · PMID 41392997

Human glycyl-tRNA synthetase (GARS), encoded by the GARS1 gene, is a key protein within the aminoacyl-tRNA synthetases family, responsible for catalyzing the attachment of glycine to its corresponding tRNA during protein synthesis. While aminoacyl-tRNA synthetases are primarily known for their role in translation, emerging evidence indicates that they also have non-canonical functions in physiological and pathological processes, including metabolism, angiogenesis, immune responses, and inflammation. This review int…

Sorafenib/piroxicam therapy with biomarker-defined survival benefit in canine muscle-invasive urothelial carcinoma.

Scientific reports · 2026 · PMID 42680778

Molecular-targeted therapies require biomarker-driven evaluation to optimize precision oncology strategies; however, translational models integrating clinical outcomes with mechanistic biomarkers are limited. Canine urothelial carcinoma shares molecular features with human muscle-invasive bladder cancer, including activation of VEGFR signaling, providing a valuable comparative oncology platform. Sorafenib is a multi-kinase inhibitor targeting VEGFRs, PDGFRβ, BRAF, and related pathways, but its therapeutic mechanism…

KLF6-driven macrophage-to-myofibroblast transition promotes PD-L1-mediated immune evasion in bladder cancer.

International immunopharmacology · 2026 · PMID 42574804

BACKGROUND: Although PD-1/PD-L1 inhibitors are central to the management of advanced bladder cancer, most patients fail to achieve a meaningful response. While evidence ties MMT to fibrotic disease, its contribution to bladder cancer has yet to be examined. METHODS: We assembled and analysed several complementary data modalities-bulk transcriptomes from TCGA-BLCA (n = 408 tumour, 19 normal) and incorporated single-cell RNA-seq, spatial transcriptomics (nine sections), and two independent immunotherapy cohorts (Kim …

Liquid biopsy miRNA risk score in bladder cancer: Translational insights from patient-derived xenografts to prognostic stratification.

European journal of cancer (Oxford, England : 1990) · 2026 · PMID 42594670

BACKGROUND: Bladder cancer (BlCa) surveillance requires lifelong invasive monitoring, imposing substantial patient burden and healthcare costs. This underscores the need for minimally-invasive precision medicine approaches. Herein, we investigated the circulating miRNome of BlCa patients to assess its clinical and translational utility. METHODS: miRNA-seq was performed on tumors and matched plasma samples from 15 patient-derived xenograft (PDX) mouse models. The screening cohort of the study consisted of 216 patien…

Microbiome-Driven Carcinogenesis and Circulating Microbial Signals in Genitourinary Cancers.

Cancer science · 2026 · PMID 42333742

The microbiome is increasingly recognized as a regulator of carcinogenesis, tumor immunity, and response to immune checkpoint inhibitors (ICIs), but its role in genitourinary cancers remains less clearly defined than in melanoma or colorectal cancer. In this review, we summarize evidence that microbiome-related pathways influence urothelial carcinoma (UC) and renal cell carcinoma (RCC) across the continuum from tumor initiation to immunotherapy outcome. We highlight recent preclinical studies showing that gut micro…

A machine learning-based epigenetic signature reveals YTHDC1 stabilizes POU5F1 to oppose tumor progression.

Journal of translational medicine · 2026 · PMID 41862905

BACKGROUND: The prognosis and progression mechanisms of bladder cancer (BLCA) are highly heterogeneous, driven by complex genetic and epigenetic alterations. This study aimed to construct a robust prognostic signature using epigenetic modification-related genes and to investigate the underlying molecular mechanisms driving its predictive power. METHODS: We developed a prognostic signature by applying a machine learning-based approach to screen epigenetic genes in the TCGA (The Cancer Genome Atlas)-BLCA cohort. Its …

Protective Effects of Luteolin Against Cisplatin-Induced Hepatic and Renal Toxicity: Biochemical and Cellular Evidence.

Journal of biochemical and molecular toxicology · 2026 · PMID 42671218

Cisplatin is a widely used chemotherapeutic agent; however, its clinical utility is frequently limited by dose-dependent adverse effects, particularly hepatotoxicity and nephrotoxicity. Luteolin, a naturally occurring flavonoid abundant in various medicinal plants, exhibits well-documented antioxidant and anticancer activities. This study investigated whether Luteolin isolated from Pistacia terebinthus fruits could attenuate Cisplatin-induced organ toxicity while enhancing its antiproliferative effects. For the in …

Enhanced magnetic hyperthermia using anti-PD-L1 antibody-conjugated magnetoliposomes in a murine subcutaneous bladder cancer model.

International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group · 2026 · PMID 41887926

BACKGROUND/OBJECTIVES: Bladder cancer (BC) often arises in an immunosuppressive tumor microenvironment that limits responses to immune checkpoint inhibitors. Magnetic hyperthermia therapy (MHT) can induce immunogenic cell death, but its value as an immunotherapeutic remains insufficient. METHODS: We conjugated anti-programmed death-ligand 1 (PD-L1) antibody (αPD-L1) with magnetite cationic liposomes (MCL) and developed αPD-L1@MCL for MHT in an MB49 murine subcutaneous BC model. Mice received a single or triple expo…

CircFut8 Suppresses Bladder Cancer by Modulating SRSF9-Dependent Pre-mRNA Splicing.

The journal of gene medicine · 2026 · PMID 42643011

OBJECTIVE: Circular RNAs (circRNAs) represent key regulators in cancer pathogenesis; however, their involvement in alternative splicing (AS) remains poorly understood. METHODS: Expression of circFut8 was detected in bladder cancer (BC) tissues/cell lines; RNA pull-down, cross-linking immunoprecipitation (CLIP) assays verified circFut8's interaction with splicing factor SRSF9. CircFut8 overexpression was performed to assess its effects on BC cell proliferation in vitro (CCK-8, colony formation) and tumor growth in v…

Transcription factor EN1 governs a lipogenic USP18-ACLY axis to drive bladder cancer malignancy.

Oncogene · 2026 · PMID 42521834

Bladder cancer (BLCA) is a lethal malignancy with limited therapeutic options. The role of the transcription factor Engrailed-1 (EN1) in BLCA metabolic reprogramming was previously unknown. Our study demonstrates that EN1 is significantly overexpressed in BLCA, correlating with poor patient survival and driving tumor progression. Mechanistically, EN1 transcriptionally upregulates the deubiquitinase USP18. USP18, in turn, prevents the proteasomal degradation of ATP-citrate lyase (ACLY), thereby stabilizing this gate…

A synergistic cascade nanoreactor breaks bladder cancer chemoresistance: Synergizing cholesterol metabolism reprogramming with cGAS-STING-mediated metallotherapy.

Materials today. Bio · 2026 · PMID 42621345

Bladder cancer chemoresistance arises from a self-reinforcing vicious cycle of aberrant cholesterol metabolism and immunosuppression, which conventional single-target therapies fail to disrupt. Here, we report a folate-targeted zeolitic imidazolate framework-67 (ZIF67)-based nanoreactor termed CCZF, co-loaded with cholesterol 25-hydroxylase (CH25H) and cisplatin, to orchestrate a metabolism-chemo-immunity cascade with mutually amplifying components. First, the intrinsic catalase (CAT)-like activity of ZIF67 generat…

Patient-derived tumor organoids for personalized cancer immunotherapy: An immunopeptidome-to-validation approach in RCC and BC.

Molecular therapy. Oncology · 2026 · PMID 42375394

Immunotherapy has revolutionized cancer treatment, yet clinical success remains limited, with only a fraction of patients responding. Tumor heterogeneity and patient-specificity hinder response prediction, emphasizing the need for human-based models that accurately reproduce tumor-immune interactions. Conventional preclinical platforms, such as murine models, lack the human-specific HLA-TCR complexity, limiting their ability to accurately evaluate immunotherapy responses. To address this, we established a patient-s…

Dual-functional chitosan-hyaluronic acid dialdehyde nanoparticles for CD44-targeted Bcl-2 siRNA delivery and photothermal therapy in bladder cancer.

Journal of biotechnology · 2026 · PMID 42162746

Bladder Cancer (BC) remains a major global health concern due to its high recurrence rate and limited availability of effective targeted therapies. Although gene therapy has emerged as a promising strategy, its clinical translation is hindered by the lack of safe and efficient delivery systems. This research aims to develop a dual-functional nanoparticle system for targeted gene delivery and enhanced therapeutic efficacy. Chitosan-Hyaluronic Acid Dialdehyde nanoparticles (CS-HAD NPs) were synthesized via controlled…

Chemotherapy-induced peripheral neuropathy: Mechanisms of toxicity and potential natural compounds-based therapeutics.

Food and chemical toxicology : an international journal published for the British Industrial Biological Research Association · 2026 · PMID 42144129

Platinum-based drugs, such as cisplatin, carboplatin, and oxaliplatin, are increasingly being used to treat a variety of cancers, including lung, ovarian, testicular, and bladder cancer, as well as a secondary treatment for other types of cancer. These drugs primarily act by targeting the DNA of cancer cells, causing DNA damage that inhibits cell division and slows cancer progression. However, the mechanism can also lead to specific side effects, such as neuropathy. Chemotherapy-induced peripheral neuropathy (CIPN)…

LC3B promotes bladder cancer cell proliferation via the Sp1-cyclin D1/p27 axis with pan-cancer clinical associations.

Cellular signalling · 2026 · PMID 42066829

Microtubule-associated protein 1 light chain 3 beta (MAP1LC3B, LC3B) is a core autophagy-related protein, yet its functional role in bladder cancer remains incompletely understood. In this study, we aimed to clarify the expression pattern, biological function, and molecular mechanism of LC3B in bladder cancer and to further assess its broader clinical relevance across human cancers. Single-cell RNA sequencing revealed that LC3B is predominantly expressed in bladder cancer epithelial cells and is closely associated …

Biomimetic delivery of a STING agonist via tumor antigen-primed dendritic cell membrane nanovesicles for bladder cancer immunotherapy.

Materials today. Bio · 2026 · PMID 42388376

STING agonists hold considerable promise for cancer immunotherapy, but their therapeutic efficacy is often limited by poor cellular delivery, rapid systemic clearance, and insufficient activation of antigen-presenting cells. Here, we report an engineered dendritic cell membrane-derived nanovesicle platform (Ag-DCNV-STINGa) for biomimetic delivery of a STING agonist in bladder cancer immunotherapy. Generated from tumor antigen primed mature human monocyte-derived dendritic cell membranes, Ag-DCNV-STINGa preserves ke…

Celastrol's covalent strike on HK2: Breaking a metabolic-epigenetic circuit to impede bladder cancer.

Pharmacological research · 2026 · PMID 42480737

This study investigated how the natural compound celastrol (CEL) impedes bladder cancer (BLCA) progression by irreversibly occupying the ATP-binding pocket of hexokinase 2 (HK2). CEL binds directly to the ATP cleft of HK2, permanently inactivating its enzymatic function and consequently suppressing glycolytic flux and lactate output in tumor cells. The diminished availability of lactate leads to reduced histone lactylation-a recently recognized epigenetic mark-which in turn downregulates the expression of the RNA m…

RBCK1 promotes chemotherapy resistance in bladder carcinoma by targeting HLTF.

Pathology, research and practice · 2026 · PMID 42470788

Bladder cancer remains highly prone to cisplatin resistance, which markedly limits therapeutic efficacy and contributes to poor clinical outcomes. Although dysregulation of E3 ubiquitin ligases has been implicated in tumor progression and drug resistance, the specific ligases that drive cisplatin resistance in bladder cancer and their underlying mechanisms remain incompletely defined. In this study, integrated analysis of public transcriptomic datasets identified RBCK1 as an aberrantly upregulated E3 ubiquitin liga…

Neoadjuvant Durvalumab ± Tremelimumab in Combination With Dose-Dense Methotrexate, Vinblastine, Doxorubicin, and Cisplatin in Muscle-Invasive Bladder Carcinoma: Results of the Phase I/II NEMIO Study.

Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2026 · PMID 42190158

PURPOSE: To evaluate the efficacy and safety of neoadjuvant dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin (ddMVAC) combined with durvalumab ± tremelimumab in patients with muscle-invasive bladder cancer (MIBC). METHODS: NEMIO (ClinicalTrials.gov identifier: NCT03549715) is a multicenter, randomized, noncomparative phase II trial in cT2-T4a N0-1 cisplatin-eligible MIBC planned for radical cystectomy (RC). Patients received ddMVAC (cisplatin 70 mg/m2, methotrexate 30 mg/m2, doxorubicin 30 mg/m2, an…

Atezolizumab in Combination With Gemcitabine and Cisplatin as First-Line Treatment in Metastatic Urothelial Cancer: A Randomized Phase II Study of Two Alternative Dosing Schedules.

Clinical genitourinary cancer · 2026 · PMID 42217273

BACKGROUND: The potential impact of treatment sequencing in chemoimmunotherapy combinations remains underexplored. We evaluated 2 alternative dosing schedules of chemotherapy (cisplatin and gemcitabine [GC]) and an immune checkpoint inhibitor (CPI; atezolizumab [A]) for metastatic urothelial carcinoma (mUC). METHODS: This multicenter phase II study randomized cisplatin-eligible patients with previously untreated mUC in a 1:1 ratio. The chemo-first schedule included 2 cycles of GC, followed by 4 cycles of GC + A and…

Tremelimumab with or without durvalumab in combination with paclitaxel in metastatic urothelial cancer: phase I/II ICRA trial.

Nature communications · 2026 · PMID 42310313

New therapeutic strategies for patients with therapy-refractory metastatic urothelial carcinoma (mUC) are still needed. In the phase I-II ICRA trial, a multicenter, open-label, phase Ib-II clinical trial (NCT03871036), we evaluated whether paclitaxel plus tremelimumab, with or without durvalumab, could induce a tumor response in mUC following platinum chemotherapy and immune checkpoint inhibition (ICI). Patients were randomized between three arms: A (n = 20) paclitaxel plus T750mg; B (n = 12) paclitaxel plus T300mg…

TROPION-Urothelial03: a phase II/III study of datopotamab deruxtecan (Dato-DXd) for locally advanced or metastatic urothelial carcinoma.

Future oncology (London, England) · 2026 · PMID 42142358

Enfortumab vedotin (EV) plus pembrolizumab is the first-line standard of care for patients with locally advanced or metastatic urothelial carcinoma (la/mUC). However, randomized data to guide treatment after progression on EV plus pembrolizumab are limited. Datopotamab deruxtecan (Dato-DXd), a trophoblast cell surface antigen 2-directed antibody-drug conjugate, has demonstrated durable efficacy and a manageable safety profile in patients with la/mUC. TROPION-Urothelial03 is a global, multicenter, randomized, open-l…

Intravesical mitomycin-C administered immediately before transurethral resection of bladder tumor in non-muscle-invasive bladder cancer: Clinical outcomes and molecular predictors from over 3 years of extended follow-up in a phase II trial.

Investigative and clinical urology · 2026 · PMID 42683856

PURPOSE: To evaluate the long-term outcomes and molecular correlates of response after immediate preoperative intravesical chemotherapy (IPeIC) with mitomycin-C (MMC) in patients with non-muscle-invasive bladder cancer (NMIBC). MATERIALS AND METHODS: In this single-center, open-label, randomized phase II trial, 33 patients received two split doses of IPeIC/MMC (40 mg/20 mL), whereas 38 patients underwent transurethral resection of bladder tumor (TURBT) alone. The primary endpoint was 3-year recurrence-free survival…

A phase Ib/II, open-label, multicenter, randomized umbrella study evaluating the combination of atezolizumab with sacituzumab govitecan in patients with locally advanced or metastatic urothelial carcinoma and previously treated with a platinum-based treatment regimen (MORPHEUS-Urothelial Carcinoma).

ESMO open · 2026 · PMID 42418909

BACKGROUND: MORPHEUS-UC (NCT03869190) is a signal-seeking, global, phase Ib/II, open-label, multicenter, randomized, umbrella study in patients with platinum-treated locally advanced or metastatic urothelial carcinoma (mUC). Patients were randomly assigned to one of seven atezolizumab (anti-programmed death-ligand 1)-based treatment combinations or atezolizumab monotherapy. We report efficacy and safety results for atezolizumab + sacituzumab govitecan (trophoblast cell surface antigen-2-directed antibody conjugate)…

Gemcitabine plus Nivolumab with Carboplatin or Oxaliplatin in Cisplatin-Ineligible Patients with Metastatic Urothelial Carcinoma: A Randomized Phase II Trial.

Clinical cancer research : an official journal of the American Association for Cancer Research · 2026 · PMID 42001507

PURPOSE: Oxaliplatin has demonstrated the ability to sensitize tumors to immune checkpoint blockade through its immunomodulatory properties in model systems of cancer. This randomized trial aimed to evaluate gemcitabine/oxaliplatin and gemcitabine/carboplatin, each combined with nivolumab, in cisplatin-ineligible patients with metastatic urothelial carcinoma (mUC). PATIENTS AND METHODS: Cisplatin-ineligible patients with mUC were randomized 1:1 to gemcitabine/carboplatin plus nivolumab or gemcitabine/oxaliplatin pl…

Association between hyperphosphatemia and overall survival among patients with advanced urothelial cancer treated with erdafitinib in phase 2/3 clinical trials.

Cancer · 2026 · PMID 42240563

BACKGROUND: Hyperphosphatemia is a recognized on-target adverse event of erdafitinib, a pan-fibroblast growth factor receptor (pan-FGFR) tyrosine kinase inhibitor with Food and Drug Administration approval to treat advanced urothelial cell carcinoma with FGFR2/3 mutations. This study hypothesized that hyperphosphatemia is a biomarker for drug activity and is associated with improved overall survival (OS) and other oncologic end points in phase 2/3 clinical trials. METHODS: Data from the phase 2 BLC2001 and cohorts …

Spatial architecture contributes to failure of bulk biomarker-guided neoadjuvant immunotherapy selection in bladder cancer: The DUTRENEO study.

Cell reports. Medicine · 2026 · PMID 42335902

Predictive biomarkers for immune checkpoint inhibitors (ICIs) are largely identified retrospectively, but their prospective clinical utility remains unproven. Here, we report DUTRENEO, a prospective randomized phase 2 trial testing whether a retrospectively validated 18-gene bulk tumor inflammation signature (TIS) can guide neoadjuvant ICI therapy in muscle-invasive bladder cancer. The trial does not meet its primary endpoint, and this demonstrates that bulk gene-expression stratification does not sufficiently enri…

Censoring patterns and inconsistent results in checkpoint inhibitor and adjuvant BCG trials for high-risk bladder cancer.

European journal of cancer (Oxford, England : 1990) · 2026 · PMID 42019224

Intravesical Bacillus Calmette-Guérin (BCG) is the standard-of-care treatment for high-risk non-muscle invasive bladder cancer (HR-NMIBC). However, patients with BCG-unresponsive disease are unlikely to benefit from further BCG. To overcome BCG unresponsiveness, the addition of immune checkpoint inhibition (ICI) to BCG has been investigated in three recently randomized controlled trials: CREST, POTOMAC, and ALBAN, studying sasanlimab, durvalumab, and atezolizumab, respectively. While CREST and POTOMAC demonstrated …

The dual legacy of BCG: a century of tuberculosis prevention and the evolving pursuit of trained immunity-based therapies.

Immunotherapy · 2026 · PMID 42427259

The Bacillus Calmette-Guérin (BCG) vaccine, a live-attenuated derivative of Mycobacterium bovis, has long been central to global tuberculosis prevention. Although it protects well against severe childhood TB, its efficacy against adult pulmonary TB is variable. At the same time, epidemiological and clinical observations suggest that BCG may reduce all-cause mortality and protect against infections beyond TB. Randomised trials have reported lower neonatal all-cause mortality and fewer sepsis-related deaths, supporti…

Efficacy and Safety of Disitamab Vedotin Combined with Gemcitabine as Neoadjuvant Therapy in Muscle-invasive Bladder Cancer: An Open-label, Multicenter, Single-arm, Phase 2 Trial.

European urology · 2026 · PMID 41193372

There are barriers to the clinical use of cisplatin-based neoadjuvant regimens in muscle-invasive bladder cancer (MIBC), especially for patients with renal dysfunction, hearing loss, heart diseases, or other severe comorbidities. Favorable efficacy and safety of disitamab vedotin (DV), an antibody-drug conjugate targeting HER2, have recently been demonstrated in urothelial carcinoma. We explored neoadjuvant gemcitabine combined with RC48 in the MIBC setting. Initially, 26 patients with clinical stage T2-4a Nx M0 MI…

Updated 5-year Survival Results from PURE-01, a Phase 2 Study of Neoadjuvant Pembrolizumab Followed by Radical Cystectomy in Patients with Muscle-invasive Bladder Cancer.

European urology · 2026 · PMID 41633898

The PURE-01 trial evaluated three cycles of pembrolizumab 200 mg followed by radical cystectomy (RC) in patients with cT2-3b N0 M0 muscle-invasive bladder cancer (MIBC) ineligible for or refusing cisplatin. A total of 155 patients were treated. We report survival outcomes after median follow-up of >60 mo and associations with pathological response rates and biomarker levels. In the intention-to-treat population, the 5-yr event-free survival rate was 68% and the 5-yr overall survival (OS) rate was 77%. In the RC coh…

Neoadjuvant Sacituzumab Govitecan in Patients With Muscle-Invasive Bladder Cancer: Primary Results of the SURE-01 Trial.

Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2026 · PMID 42218654

PURPOSE: To evaluate neoadjuvant sacituzumab govitecan (SG), followed by radical cystectomy (RC), in patients with muscle-invasive bladder cancer (MIBC) who are ineligible for/refuse neoadjuvant chemotherapy (NAC). We report the results of the primary analysis and biomarker analyses of the phase II SURE-01 trial (ClinicalTrials.gov identifier: NCT05226117). PATIENTS AND METHODS: Patients were age 18 years and older, had Eastern Cooperative Oncology Group performance status 0-1, had histologically confirmed cT2-T4aN…

Addition of Intravesical Recombinant Bacillus Calmette-Guérin to Perioperative Chemoimmunotherapy in Muscle-Invasive Bladder Cancer: Primary Analysis of the Single-Arm Phase II Trial SAKK 06/19.

Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2026 · PMID 42212670

PURPOSE: Intravesical Bacillus Calmette-Guérin (BCG) is highly effective in non-muscle-invasive bladder cancer (MIBC) but has not been evaluated in MIBC. The recombinant BCG vaccine VPM1002BC (rBCG) has potentially enhanced immunogenicity and an improved safety profile. We investigated neoadjuvant intravesical rBCG combined with chemoimmunotherapy in MIBC. PATIENTS AND METHODS: SAKK 06/19 was an open-label single-arm phase II trial for cT2-T4a N0-1 MIBC eligible for cisplatin and radical cystectomy with lymph node …

The combination of atezolizumab and BCG in high-risk non-muscle invasive bladder cancer: results of the phase Ib/II BladderGATE clinical trial.

The oncologist · 2026 · PMID 42103978

BACKGROUND: BladderGATE evaluated the safety, tolerability, and efficacy of intravenous (IV) atezolizumab combined with intravesical Bacillus Calmette-Guérin (BCG) in patients with BCG-naïve high-risk non-muscle invasive bladder cancer (NMIBC). MATERIALS AND METHODS: This was a phase Ib/II open-label, nonrandomized, dose de-escalation clinical trial of atezolizumab (1200 mg IV infusion on day 1 of each 21-day cycle) plus BCG (1 instillation/week) with an induction treatment period of 6 weeks, followed by a maintena…

Efficacy, Safety, and Biomarker Analysis of Toripalimab Monoclonal Antibody Combined With Gemcitabine and Cisplatin Chemotherapy as Neoadjuvant Treatment in Muscle-Invasive Bladder Cancer: A Phase II Clinical Trial.

The Journal of urology · 2026 · PMID 41701948

PURPOSE: We evaluated the efficacy and safety of toripalimab combined with gemcitabine and cisplatin as the neoadjuvant treatment (NAT) before radical cystectomy (RC) in patients with muscle-invasive bladder cancer (MIBC). MATERIALS AND METHODS: This phase II trial enrolled 30 patients with T2-3N0M0 MIBC scheduled for RC. Patients received a treatment regimen of toripalimab 240 mg, gemcitabine 1000 mg/m2, and cisplatin 70 mg/m2 on day 1, followed by gemcitabine 1000 mg/m2 on day 8, in 21-day cycles for a total of 4…

Tislelizumab combined with gemcitabine as first-line treatment in cisplatin-ineligible patients with locally advanced or metastatic urothelial carcinoma: a single center, single-arm phase 2 trial.

Frontiers in immunology · 2026 · PMID 42338591

INTRODUCTION: Patients with la/mUC have an unfavorable prognosis and limited treatment options, particularly those who were considered ineligible for cisplatin-containing therapeutic schedule. ICIs have played a significant therapeutic role among this group of patients. Ongoing clinical investigations continue to explore the utility of ICIs, both used alone or in combination with other treatment methods. METHODS: The purpose of this clinical trial is to explore the efficacy and safety of gemcitabine combined with t…

Long-term follow-up of a phase 1/2 trial of anti-GDF-15 antibody visugromab plus anti-PD-1 antibody nivolumab in anti-PD-1/-L1 relapsed/refractory solid tumors.

Journal of hematology & oncology · 2026 · PMID 42426863

BACKGROUND: Resistance to anti-PD-1/PD-L1 therapy is a major unmet need. Growth Differentiation Factor 15 (GDF-15) has been identified as a key resistance factor for anti-PD-1/PD-L1 immunotherapy. Visugromab, a neutralizing anti-GDF-15 antibody, plus the anti-PD-1 antibody nivolumab (V+N) was evaluated in the first-in-human phase 1/2a GDFATHER-01 trial in heavily pretreated participants with locally advanced/metastatic non-squamous non-small-cell lung cancer (nsq NSCLC), urothelial carcinoma (UC), or hepatocellular…

Stem-Cell-Derived Biologic Ventricular Assist Tissue in Heart Failure.

The New England journal of medicine · 2026 · PMID 42202318

BACKGROUND: Biologic ventricular assist tissue (BioVAT) is formulated from engineered heart muscle composed of cardiomyocytes and stromal cells derived from allogeneic induced pluripotent stem cells for cardiac remuscularization in patients with heart failure and a reduced left ventricular ejection fraction. METHODS: We conducted an open-label, phase 1-2 study of tissue-engineered heart repair by means of BioVAT transplantation. Patients with heart failure and a left ventricular ejection fraction of 35% or less and…

Radiation and Avelumab in Cisplatin-Ineligible Patients With Muscle-Invasive Bladder Cancer.

Clinical genitourinary cancer · 2026 · PMID 41955932

INTRODUCTION: Trimodality therapy is a bladder-preserving treatment approach for select patients with muscle-invasive bladder cancer (MIBC), and the addition of a concurrent radiosensitizing chemotherapy to bladder radiation improves outcomes. However, a subset of patients is unwilling or unable to receive concurrent chemotherapy with radiation, and the optimal treatment strategy for these patients is unknown. PATIENTS AND METHODS: We performed a single-arm Phase II investigator-initiated trial of radical dose blad…

Erdafitinib in Patients With Advanced Solid Tumors With FGFR Alterations (RAGNAR): Results of Tumor-Specific Analyses and Secondary Cohorts.

JCO precision oncology · 2026 · PMID 42456086

PURPOSE: Erdafitinib, a pan-fibroblast growth factor receptor (FGFR) tyrosine kinase inhibitor, is approved for second-line treatment of locally advanced or metastatic urothelial carcinoma with susceptible FGFR3 alterations. Primary histology-agnostic analysis from the phase II RAGNAR study (ClinicalTrials.gov identifier: NCT04083976) indicated a clinical benefit with erdafitinib in Broad Panel Cohort (BPC) patients. We present tumor-specific updated efficacy and safety results from the BPC and tumor-agnostic findi…

Outcomes for females versus males treated with eribulin mesylate for advanced urothelial carcinoma.

Current problems in cancer · 2026 · PMID 42102451

PURPOSE: Multiple studies of bladder cancer noted worse outcomes in females compared to males. Few focused on prospective comparisons of sex regarding treatment response, survival, and toxicity. This phase 2 study compared outcomes of males and females with locally advanced and metastatic urothelial carcinoma treated with eribulin mesylate. METHODS: Patients were treated with eribulin on days 1 and 8 of a 21-day cycle. Primary endpoint was best observed response (ORR) per RECIST. Secondary endpoints included diseas…

A phase II study to evaluate the efficacy of commercially available molecularly matched targeted therapies in the second-line setting.

The oncologist · 2026 · PMID 42485262

BACKGROUND: Initial studies have shown improved outcomes in patients receiving cancer therapies matched to their molecular alterations. To improve the chances of finding a therapeutic match for patients, this study evaluated the preliminary antitumor activity of 3 commercially available multitargeted agents in the United States, regorafenib, afatinib, and cabozantinib. METHODS: In this phase II trial, patients who did not benefit from first-line treatment for non-small cell lung cancer (NSCLC), upper aerodigestive …

EV-103 dose escalation/cohort A: 5-year follow-up of enfortumab vedotin plus pembrolizumab in previously untreated locally advanced/metastatic urothelial carcinoma.

ESMO open · 2026 · PMID 42155320

BACKGROUND: Dose escalation/cohort A of the phase Ib/II EV-103/KEYNOTE-869 study (NCT03288545) assessed safety and efficacy of enfortumab vedotin (EV) plus pembrolizumab (P) in cisplatin-ineligible patients with previously untreated locally advanced/metastatic urothelial carcinoma (la/mUC). Here we report updated results after 5 years of follow-up. METHODS: Patients received EV 1.25 mg/kg intravenously on days 1 and 8, and pembrolizumab 200 mg on day 1 of every 3-week cycle. The primary endpoint was safety. Select …

Body Size and Bladder Cancer Risk: A Pooled Analysis of Prospective Studies From the National Cancer Institute Cohort Consortium.

Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2026 · PMID 41996653

PURPOSE: Body size is an established risk factor for several cancers, but associations with bladder cancer risk remain unclear. METHODS: We pooled data from 2,533,008 participants in 30 international cohort studies to assess associations of BMI, waist circumference, and height with bladder cancer risk. Multivariable Cox regression models, including smoking status, duration, and other confounders, were run separately by cohort and sex, and results combined by random-effects meta-analysis. RESULTS: Incident first pri…

Time-of-Day Immunotherapy Administration and Outcomes in Advanced Cancers: A Systematic Review and Meta-Analysis.

JAMA network open · 2026 · PMID 42084869

IMPORTANCE: Circadian rhythms affect immunity, which could affect the effectiveness of immune checkpoint inhibitor (ICI). Whether the time of ICI administration is associated with clinical outcomes in advanced cancers remains unclear. OBJECTIVE: To evaluate the association between time of day of ICI administration and oncologic outcomes in patients with advanced solid tumors. DATA SOURCES: MEDLINE (via PubMed), Embase, and Web of Science Core Collection were searched in February 2026 to identify eligible studies. S…

Liquid Biopsies for Cancer: A Translational Science Review.

JAMA · 2026 · PMID 42574031

IMPORTANCE: Circulating tumor DNA (ctDNA) evaluation, in which fragments of tumor DNA circulating in a patient's bloodstream are extracted and analyzed, can be used to monitor cancer progression, detect residual cancer after treatment, and identify genetic changes within cancer cells that could affect treatment response. OBSERVATIONS: ctDNA sequencing identifies cancer cell gene variants that inform the selection of molecularly directed therapies in several types of cancer, including non-small cell lung cancer, col…

Vegetarian and vegan diets and cancer incidence: a systematic review and meta-analysis of prospective studies.

European journal of epidemiology · 2026 · PMID 41879966

Several studies have suggested that vegetarian and vegan vs. non-vegetarian diets are associated with lower cancer risk overall, however, results for specific cancer sites have been less consistent. We conducted a systematic review and meta-analysis of prospective studies on vegetarian and vegan diets and cancer incidence to clarify the associations across cancer sites. PubMed and Embase databases were searched for relevant studies up to 5 July 2025. Summary relative risks (RRs) and 95% confidence intervals (95% CI…

Prospective comparative evaluation of clinical efficacy and safety of Intravesical gemcitabine-docetaxel versus BCG in adjuvant management of BCG-naive non-muscle invasive urothelial bladder cancer in Indian population.

International urology and nephrology · 2026 · PMID 41843343

BACKGROUND: Intravesical Bacillus Calmette-Guérin (BCG) is the standard adjuvant therapy for intermediate/high-risk non-muscle-invasive bladder cancer (NMIBC) but is limited by failure, toxicity, and global supply constraints. Sequential Intravesical gemcitabine-docetaxel (Gem/Doce) can offer a rational chemotherapy alternative. METHODS: In this prospective randomized, parallel-arm interventional study comparing efficacy and safety of Gem/Doce versus BCG in BCG-naïve intermediate/high-risk NMIBC, patients aged 18-8…

Comparison of quality of life and sexual function after ileal vs. sigmoid orthotopic neobladder reconstruction following nerves, vas deferens, and seminal vesicle-sparing radical cystectomy: A prospective randomized study.

Urologic oncology · 2026 · PMID 42217279

INTRODUCTION: Radical cystectomy with orthotopic urinary diversion is a standard treatment for muscle-invasive bladder cancer. However, the impact of different bowel segments used for neobladder reconstruction on postoperative quality of life and sexual function remains underexplored. This prospective randomized study compared the outcomes of orthotopic ileal neobladders (INB) and sigmoid neobladders following nerve-sparing, vas deferens-sparing, seminal vesicle-sparing, and partial prostate-sparing radical cystect…

Anesthetic approaches and 2-year recurrence rates in non-muscle invasive bladder cancer: a randomized clinical trial.

Regional anesthesia and pain medicine · 2026 · PMID 39740955

BACKGROUND: The effect of anesthesia methods on non-muscle invasive bladder cancer (NMIBC) recurrence post-resection remains uncertain. We aimed to compare the oncological outcomes of spinal anesthesia (SA) and general anesthesia (GA) in patients with NMIBC. METHODS: This prospective randomized controlled trial recruited 287 patients with clinical NMIBC at Seoul National University Hospital from 2018 to 2020. The patients underwent transurethral resection of the bladder tumor within 4 weeks of randomization. Intrat…

Effect of Catheter Type and Size on Patient Comfort and Complications in Intravesical Bacillus Calmette-Guérin and Chemotherapy Administration: A Randomized Prospective Pilot Study.

Urology · 2026 · PMID 41831698

OBJECTIVE: To evaluate the impact of catheter type and size on patient-reported pain, anxiety, and adverse events during intravesical therapy. METHODS: A total of 200 patients were screened, and 179 were randomized into 4 groups: Foley 12 Fr (n = 31), Foley 8 Fr (n = 60), Nelaton 12 Fr (n = 46), and Nelaton 8 Fr (n = 42). Pain was assessed using the Visual Analog Scale (VAS), anxiety using the Beck Anxiety Inventory (BAI), and complications were recorded for 1 week following instillation. RESULTS: Compared with Fol…

PA- versus urologist-performed flexible cystoscopy: A comparative study.

JAAPA : official journal of the American Academy of Physician Assistants · 2026 · PMID 41723868

INTRODUCTION: We aimed to compare patient pain perceptions and bladder cancer detection rates following cystoscopy performed by physician associates/physician assistants (PAs) versus staff urologists (SUs). METHODS: We performed a secondary analysis of our earlier single-center, prospective, double-blind, randomized controlled trial that originally investigated irrigation "bag squeeze" versus standard cystoscopy. In this analysis, 98 men who underwent flexible cystoscopy by either a SU or a PA were included. Patien…

Results From the ERAS for Ambulatory TURBT: Enhancing Bladder Cancer Care (EMBRACE) Randomized Controlled Trial.

The Journal of urology · 2026 · PMID 41662513

PURPOSE: Transurethral resection of a bladder tumor (TURBT) contributes to morbidity of patients with bladder cancer. This trial evaluates the impact of an enhanced recovery after surgery (ERAS) protocol on quality of recovery from ambulatory TURBT. MATERIALS AND METHODS: In a prospective, single institution randomized controlled trial, patients undergoing ambulatory TURBT were randomized to ERAS (including preoperative patient education, intraoperative and postoperative anesthesia/surgery interventions) or usual c…

In-Office Laser Coagulation of Ta Bladder Tumor Compared With Transurethral Resection of Bladder Tumor: 12 Months Follow-Up Randomized Clinical Trial.

The Journal of urology · 2026 · PMID 41461083

PURPOSE: Ta low-grade bladder tumors, accounting for 45% of new bladder cancer cases, have considerable risk of recurrence but low risk of progression. Traditionally, treatment is burdensome and costly. Office-based laser coagulation of Ta low-grade bladder tumors is efficient, tolerable, and safe; however, long-term outcomes need to be determined. The primary objective of this study was to determine whether in-office laser coagulation of recurrent Ta low-grade bladder tumor is noninferior to standard transurethral…

Immediate intraoperative detrusor muscle status at primary transurethral resection of bladder tumour: a prospective, blinded, paired cohort, feasibility study using fluorescence confocal microscopy (IB1-LaserComplete study).

BJU international · 2026 · PMID 42596073

OBJECTIVES: To evaluate ex vivo fluorescence confocal microscopy (FCM) for immediate detrusor muscle (DM) assessment during primary transurethral resection of bladder tumour (TURBT). PATIENTS AND METHODS: This prospective, blinded, paired-cohort feasibility study enrolled consecutive patients undergoing primary TURBT for suspected non-muscle-invasive bladder cancer between September 2024 and September 2025 (IB1-LaserComplete study; International Standard Randomised Controlled Trial Number Register [ISRCTN]16114765)…

Detection of bladder cancer in patients with microscopic hematuria using Oncuria-Detect: results of a prospective, multicenter international study.

Journal of translational medicine · 2026 · PMID 42106837

BACKGROUND: Microscopic hematuria occurs in up to 10% of the general population and initiates costly evaluation to ensure no bladder cancer exists. Oncuria-Detect is a 10-plex immunoassay that detects de novo bladder cancer by generating a protein biomarker signature from a single voided urine sample. This report details the analysis of our prospective study that compares the diagnostic performance of the multiplex Oncuria-Detect assay to that of the single-analyte (i.e., NMP22) BladderChek™ urine assay and urine c…

Phase 2 Trial of Intravesical Gemcitabine and Docetaxel as First-Line Treatment of Bacillus Calmette-Guérin‒Naïve Nonmuscle-Invasive Urothelial Carcinoma: Updated, 3-Year Outcomes.

The Journal of urology · 2026 · PMID 42330429

PURPOSE: Combination intravesical gemcitabine-docetaxel (Gem/Doce) has demonstrated efficacy in bacillus Calmette-Guérin (BCG)‒unresponsive high-risk (HR) nonmuscle-invasive bladder cancer (NMIBC). However, its efficacy as first-line treatment for BCG-naïve HR NMIBC is unknown. We previously reported recurrence-free survival (RFS) at 1 year. In this article, we present updated 3-year outcomes. MATERIALS AND METHODS: This study is a prospective, single-arm, open-label phase 2 trial for patients with BCG-naïve HR NMI…

Application of transformer-enhanced convolutional neural network: multicenter MRI assessment of muscle invasion in bladder cancer.

European radiology · 2026 · PMID 41934494

OBJECTIVE: Accurate preoperative assessment of muscle invasion in bladder cancer (BCa) guides therapy selection. However, MRI interpretation varies across readers and lesion morphologies. Therefore, we aimed to overcome the morphology-associated diagnostic bias through a deep learning method. MATERIALS AND METHODS: This multicenter study included 1374 patients with BCa. An nnU-Net was fine-tuned to assist in lesion segmentation on T2-weighted images, providing inputs for a 2.5D ConvNeXt-tiny model to assess muscle …

Fruit and vegetable consumption, dietary and plasma carotenoids and risks of recurrence and progression in patients with non-muscle-invasive bladder cancer.

European journal of nutrition · 2026 · PMID 42627386

PURPOSE: Fruit and vegetable consumption may decrease bladder cancer risk, but research on its relation to outcomes of non-muscle-invasive bladder cancer (NMIBC) is scarce. We investigated the association of (changes in) pre- and postdiagnosis fruit and vegetable consumption, as well as postdiagnosis dietary and plasma carotenoids, with risks of recurrence and progression in patients with NMIBC. METHODS: Data from patients with newly diagnosed NMIBC between 2014 and 2021 from the prospective multi-centre cohort Uro…

The role of Bladder EpiCheck® test in predicting residual tumor after transurethral resection of bladder cancer: Results from a pilot study.

Urologia · 2026 · PMID 41992667

Bladder EpiCheck® (Nucleix Ltd, Israel) is a molecular urine assay detecting DNA methylation alterations associated with bladder cancer. This pilot study aimed to evaluate its diagnostic performance in predicting residual tumor in patients undergoing re-transurethral resection of bladder tumor (reTURB) according to international guidelines. After ethical approval, 79 patients were prospectively enrolled at two academic centers. Voided urine samples were collected before initial TURB and analyzed, generating an EpiS…

Large multicenter validation of urine RNA profile for urothelial carcinoma detection and surveillance.

The Journal of clinical investigation · 2026 · PMID 41955017

BACKGROUNDCurrent diagnosis and surveillance of bladder cancer rely on cystoscopy, which is invasive and user dependent. The urine mRNA panel, uRNAp, measures expression of 3 genes for identification of bladder cancer. Here we report validation of uRNAp for patients undergoing initial workup for suspected bladder cancer and surveillance for bladder cancer.METHODSUrine specimens were prospectively collected prior to cystoscopy at 2 health care systems from patients without (detection cohort) or with (surveillance co…

Diagnostic performance analysis of two-gene methylation in urothelial carcinoma based on small-volume urine sample.

Cancer · 2026 · PMID 41874814

BACKGROUND: Early detection of urothelial carcinoma (UCa) remains challenging because of the limitations of current diagnostic methods. The objective of this study was to evaluate a novel, urine-based H4C6/TWIST1 methylation assay for its diagnostic accuracy in UCa. METHODS: In a prospective, multicenter study, 743 urine samples (387 patients with UCa and 356 controls) from four hospitals were analyzed. DNA was extracted from 3.5 mL of morning urine, and H4C6/TWIST1 methylation status was assessed by using quantita…

Digital PCR-Based Uromonitor for Molecular Detection of Bladder Cancer: A Multicenter Validation Study Comparing Quantitative PCR and Urine Cytology.

Clinical genitourinary cancer · 2026 · PMID 42049549

INTRODUCTION: Non-invasive urine-based diagnostics for urothelial carcinoma of the bladder remain limited by suboptimal sensitivity. We validated a digital polymerase chain reaction (dPCR) UromonitorⓇ assay in a multicentre setting and compared it with an earlier quantitative polymerase chain reaction (qPCR) version and urine cytology. PATIENTS AND METHODS: We analyzed 239 archived urine samples from a prospectively assembled biobank, including 123 patients with histologically confirmed urothelial carcinoma of the …

Effectiveness and safety of avelumab maintenance in patients aged ≥75 years with advanced urothelial cancer: a sub-analysis of the meet-URO 25 (MALVA) study.

Frontiers in immunology · 2026 · PMID 42367804

BACKGROUND: Avelumab maintenance therapy is an established therapeutic approach for patients with advanced urothelial carcinoma (UC) whose disease has not progressed after first-line platinum-based chemotherapy. However, evidence on its effectiveness and safety in elderly patients remains limited. METHODS: This multicenter retro-prospective Italian study included 251 patients with advanced UC who received avelumab maintenance between 2021 and 2023. Outcomes were compared between patients aged ≥75 and <75 years. Pri…

Design and Rationale of the ROGUE-1 Registry: A Multicentric Prospective Registry for Primary T1 Nonmuscle-invasive Bladder Cancer.

European urology oncology · 2026 · PMID 42000298

BACKGROUND AND OBJECTIVE: Patients with T1 nonmuscle-invasive bladder cancer (NMIBC) face substantial risks of recurrence and progression to muscle-invasive disease. However, current risk stratification tools rely on retrospective data with significant heterogeneity in the reporting of adverse pathological features. The ROGUE-1 registry was designed to address the unmet need for a clean, prospective dataset on primary T1 bladder cancer to enable accurate risk stratification and guide clinical decision-making. METHO…

Intravesical hematoporphyrin photodynamic therapy combined with pirarubicin for intermediate and high-risk non-muscle-invasive bladder cancer: A multicenter, prospective single-arm cohort.

Photodiagnosis and photodynamic therapy · 2026 · PMID 41698628

INTRODUCTION: Photodynamic therapy (PDT) has been investigated as an alternative treatment modality for non-muscle-invasive bladder cancer (NMIBC); however, its clinical application has been limited due to lack of high-quality evidence. We conducted a multicenter prospective cohort study to evaluate the efficacy and safety of combining PDT with intravesical chemotherapy in the management of NMIBC. PATIENTS AND METHODS: This multicenter, prospective, single-arm cohort study (registered with the Chinese Clinical Tria…

Liquid biopsy based on multi-targeted capture of urinary tumor DNA combined with machine learning to detect urothelial carcinoma: a multicenter prospective study.

International urology and nephrology · 2026 · PMID 40996609

PURPOSE: Diagnostics for urothelial carcinoma have low sensitivity, thereby negatively impacting diagnostic outcomes. Herein, we present BiovueUro, a machine learning-based urine DNA biomarker tool for urothelial carcinoma detection. We developed BiovueUro to monitor DNA mutation and methylation in urine samples. METHODS: The study involved 63 patients with malignant urothelial carcinoma, 13 patients with benign lesions, 115 patients with urinary symptoms, and 106 healthy participants undergoing physical check-ups.…

Second Transurethral Resection of Bladder Tumor Can Be Safely Omitted in Selected Patients with T1 Non-muscle-invasive Bladder Cancer: Results from the Prospective HuNIRe Trial.

European urology oncology · 2026 · PMID 41654427

BACKGROUND AND OBJECTIVE: Current European Association of Urology guidelines universally recommend a second transurethral resection (ReTUR) for all T1 non-muscle-invasive bladder cancer (NMIBC) cases. However, ReTUR is an invasive and costly procedure that is often negative for residual disease, and may represent overtreatment in appropriately selected patients who have undergone complete initial TUR. Our aim was to report 2-yr oncological outcomes and confirm the safety of a novel, response-guided strategy with se…

Optimal Management of Muscle-invasive Bladder Cancer: Recommendations from the International Bladder Cancer Group.

European urology · 2026 · PMID 41724648

BACKGROUND AND OBJECTIVE: The management of muscle-invasive bladder cancer (MIBC) is evolving rapidly with the emergence of new perioperative treatments and approaches for bladder preservation. We provide guidance on clinical staging and optimal therapeutic sequencing for patients with MIBC in clinical practice and within the context of clinical trial design. METHODS: The International Bladder Cancer Group (IBCG) convened global experts in bladder cancer to develop recommendations for the management of MIBC and to …

Effects of self-management interventions on self-care ability and quality of life in patients with urinary ostomy after bladder cancer: a systematic review and meta-analysis.

Frontiers in oncology · 2026 · PMID 42577118

OBJECTIVE: To systematically assess the effects of structured self-management interventions on self-care ability, quality of life (QoL), anxiety, and stoma-related complications in bladder cancer patients with urinary ostomy, providing evidence to guide clinical practice and intervention design. METHODS: A systematic search of CNKI, WanFang, VIP Database, CINAHL, Cochrane Library, PubMed, Embase, and Web of Science was conducted from January 1, 2016, to January 1, 2026. Randomized controlled trials evaluating self-…

Sexual life and intimate relationship experience among bladder cancer patients: a systematic review and qualitative meta-synthesis.

Frontiers in public health · 2026 · PMID 42688463

OBJECTIVES: The global incidence of bladder cancer continues to rise. Treatments for this disease, particularly radical cystectomy and urinary diversion, can profoundly disrupt sexual function and intimate relationships, leading to physiological, psychological, relational, and existential changes. However, qualitative evidence syntheses that integrate these experiences remain limited. This review aimed to synthesize qualitative research on bladder cancer patients' sexual life and intimate relationship experiences i…

Patient-Reported Outcome Instruments in Non-Muscle-Invasive Bladder Cancer (NMIBC): A Systematic Review.

Oncology and therapy · 2026 · PMID 42642612

INTRODUCTION: Non-muscle-invasive bladder cancer (NMIBC) is a chronic and recurrent condition requiring repeated intravesical treatments and lifelong surveillance, imposing a substantial burden on patients. Patient-reported outcomes (PROs) are increasingly required by regulatory bodies and HTA bodies to capture treatment impact from the patient perspective, yet no consensus on the optimal PRO instruments for use in NMIBC trials exists. This systematic review evaluated PRO instruments used in NMIBC and appraised the…

Update of the EORTC Health-related Quality of Life Modules for Bladder Cancer: Phase 1-2 of the Development Process.

European urology oncology · 2026 · PMID 42191529

BACKGROUND AND OBJECTIVE: To determine whether the existing European Organisation for Research and Treatment of Cancer (EORTC) QLQ-NMIBC24 and QLQ-BLM30 modules remain fit for purpose and to assess health-related quality of life (HRQoL) issues relevant for patients with metastatic bladder cancer (mBC). METHODS: Following the EORTC Quality of Life Group (QLG) guidelines, phase 1 included an expert meeting, five systematic reviews, and interviews with 14 healthcare professionals (HCPs) and 48 bladder cancer (BC) pati…

Comparison of quality of life and sexual function after ileal vs. sigmoid orthotopic neobladder reconstruction following nerves, vas deferens, and seminal vesicle-sparing radical cystectomy: A prospective randomized study.

Urologic oncology · 2026 · PMID 42217279

INTRODUCTION: Radical cystectomy with orthotopic urinary diversion is a standard treatment for muscle-invasive bladder cancer. However, the impact of different bowel segments used for neobladder reconstruction on postoperative quality of life and sexual function remains underexplored. This prospective randomized study compared the outcomes of orthotopic ileal neobladders (INB) and sigmoid neobladders following nerve-sparing, vas deferens-sparing, seminal vesicle-sparing, and partial prostate-sparing radical cystect…

Collecting electronic patient-reported outcomes via smartphone text messages in a bladder cancer RCT: A feasibility study.

Urologic oncology · 2026 · PMID 42235120

Patient-reported outcome measures are increasingly used to assess symptoms, treatment tolerance, and quality of life (QoL) in oncology. Electronic patient-reported outcome measures (ePROM) offer advantages over paper questionnaires, but large-scale evidence using smartphone text messaging in clinical trials is limited. To evaluate the feasibility of collecting ePROM via smartphone text messages in a large-scale, multinational randomized controlled trial of patients receiving Bacillus Calmette-Guérin therapy for non…

Network meta-analysis of immune checkpoint inhibitors in BCG-naïve, high-risk non-muscle-invasive bladder cancer.

Urologic oncology · 2026 · PMID 42448544

PURPOSE: Bacillus Calmette-Guérin (BCG) remains the standard first-line therapy for BCG-naïve high-risk non-muscle-invasive bladder cancer (NMIBC), yet recurrence and progression remain clinically significant. Multiple phase III trials have evaluated immune checkpoint inhibitors (ICIs) combined with BCG, but the relative efficacy of individual agents and the influence of carcinoma in situ (CIS) remain unclear. We performed a network meta-analysis (NMA) to compare ICI-based regimens and assess treatment ranking, wit…

Enfortumab Vedotin in Advanced or Metastatic Urothelial Carcinoma: A Systematic Review of Efficacy, Safety, and Clinical Perspectives.

Cancers · 2026 · PMID 42512387

Background: Urothelial carcinoma (UC) is a significant clinical problem, especially in locally advanced and metastatic stages, where the prognosis remains poor despite advances in immunotherapy. Enfortumab vedotin (EV), an antibody-drug conjugate (ADC) targeting Nectin-4, extends beyond direct cytotoxicity by actively modulating the immunosuppressive tumor microenvironment (TME) in preclinical models, creating a strong rationale for combination strategies. This systematic review aimed to evaluate the clinical effic…

Threading the Needle in Bladder Cancer: A Narrative Review of the Emerging Role of Integrative Oncology in Treatment-Related Adverse Events in the Era of Immunotherapy and Antibody-Drug Conjugates.

Cureus · 2026 · PMID 42488263

Bladder cancer is a common malignancy with substantial morbidity, and recent advances in immune checkpoint inhibitors, antibody-drug conjugates, and targeted therapies have improved outcomes across disease stages. Despite these gains, emerging therapies are associated with substantial treatment-related adverse events (TRAEs), including neuropathy, rash, gastrointestinal, ocular, and immune-mediated toxicities, often leading to dose reductions or therapy discontinuation. In this review, we aim to examine the landsca…

Use of Shared Decision-Making in Non-Muscle-Invasive Bladder Cancer: Protocol for a Scoping Review.

JMIR research protocols · 2026 · PMID 42060468

BACKGROUND: With a growing range of treatment options for non-muscle-invasive bladder cancer (NMIBC), the emergence of longitudinal patient-reported quality-of-life data, and an aging population managing the treatment burden of coexisting conditions, there is an increasing need for shared decision-making processes and tools to support urologists and patients in navigating complex treatment decisions. What remains unknown is how shared decision-making is currently incorporated into NMIBC treatment decisions and whic…

Immune checkpoint inhibitors in urothelial carcinoma: a practical framework for patient selection, toxicity management, response assessment, and treatment sequencing.

Expert review of anticancer therapy · 2026 · PMID 41660943

INTRODUCTION: Managing urothelial carcinoma with immune checkpoint inhibitors requires addressing issues beyond clinical outcomes. Implementation difficulties affect most patients, predictive biomarkers show limited utility, and treatment discontinuation from toxicity remains problematic. AREAS COVERED: This article integrates clinical trials, systematic reviews, health-system evaluations, and guidelines from 2016 to 2025. We detail limitations of programmed death-ligand 1 (PD-L1) expression, panel-based tumor muta…

Effectiveness of a personalised 6-month programme on physical frailty in older patients treated for bladder or kidney cancer - FRAGECO program - multicenter, controlled, randomized study protocol.

BMC geriatrics · 2026 · PMID 42286520

BACKGROUND: Older adults with bladder or kidney cancer are particularly vulnerable to functional decline and postoperative complications that can exacerbate frailty. Conventional care models focus mainly on surgery and postoperative recovery, with limited continuity of support, resulting in suboptimal long-term functional outcomes. The aim is to evaluate the effectiveness of a personalized 6-month care pathway on reducing physical frailty in older adults undergoing surgery for bladder or kidney cancer, compared wit…

Symptom-guided reduction of BCG dwell time: findings from the north-REG randomized trial.

BJU international · 2026 · PMID 42538302

OBJECTIVES: To evaluate the impact of personalized dwell-time (DT) reductions on symptom prevalence and systemic toxicities in patients undergoing Bacillus Calmette-Guérin (BCG) instillation for non-muscle invasive bladder cancer (NMIBC). METHODS: Within a multinational randomized controlled trial (North-REG Dwell Time Study [NCT04701151]), 225 patients provided daily electronic patient-reported outcomes data during BCG induction and maintenance cycles. Participants were randomized 1:1, stratified by clinical site,…

Unilateral cutaneous ureterostomy with separate stomata vs ileal conduit after radical cystectomy.

World journal of nephrology · 2026 · PMID 42395668

BACKGROUND: Urinary diversion (UD) after radical cystectomy (RC) is a complex surgery that has effects on different patient aspects. The optimal UD method should be technically simple, functionally effective, and socially satisfying. The persistent controversy over the optimal method of UD is the rationale for conducting this study, given the characteristics of the population in our region. Simple UD methods include ureterocutaneous and ileal conduit (IC). AIM: To compare the surgical outcomes and to identify the f…

Bladder Preservation Therapy in Muscle-Invasive Bladder Cancer: Current Evidence and Future Directions.

Journal of clinical medicine · 2026 · PMID 42452561

Bladder preservation has emerged as an established treatment option for selected patients with muscle-invasive bladder cancer (MIBC), offering durable oncologic control with the potential to maintain native bladder function and quality of life. Over the past several decades, prospective trials and large institutional experiences have refined trimodality therapy (TMT)-maximal transurethral resection followed by definitive radiation therapy with concurrent radiosensitizing systemic therapy-and clarified principles of…

Risk factors for chemotherapy-induced dysgeusia in patients receiving dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin therapy: a retrospective observational study.

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026 · PMID 42517935

PURPOSE: Chemotherapy-induced (CI) dysgeusia is a common adverse event that impairs nutritional status and quality of life; however, its risk factors remain poorly understood. This study aimed to identify risk factors for CI dysgeusia in patients receiving dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin (dd-MVAC) therapy. METHODS: We conducted a single-center retrospective observational study including patients with urothelial carcinoma who received dd-MVAC therapy between August 2018 and March 202…

Analysis of factors influencing changes in patient-reported quality of life among patients with bladder cancer.

European journal of oncology nursing : the official journal of European Oncology Nursing Society · 2026 · PMID 42061181

PURPOSE: To analyze changes in patient-reported health-related quality of life and its influencing factors among bladder cancer patients at 3months postoperatively, and to provide evidence for improving patients' quality of life. METHODS: A prospective observational study was conducted at a tertiary Grade A hospital in Shaanxi Province, China, enrolling 218 bladder cancer patients using convenience sampling. Clinical and sociodemographic data were collected during hospitalization. Health-related quality of life (HR…

Latent profile analysis of health-related quality of life in patients with bladder cancer and abdominal wall stomas: a multicenter cross-sectional study.

BMC urology · 2026 · PMID 42443879

Abdominal wall stomas in bladder cancer patients can severely impact physical, psychological, and social adjustment. However, individual differences in patients' self-reported outcomes and their influencing factors require further investigation. This multicenter cross-sectional study aimed to identify latent profiles of health-related quality of life among bladder cancer patients with abdominal wall stomas and to examine demographic and clinical factors associated with profile membership.We evaluated 598 patients w…

Bladder preservation vs. radical cystectomy for T2N0M0: trends and survival outcomes from SEER.

World journal of urology · 2026 · PMID 42606609

PURPOSE: To compare treatment trends and survival between bladder‑preserving (BP) therapy and radical cystectomy (RC) in patients with T2N0M0 muscle‑invasive bladder cancer (MIBC) using a large population‑based cohort. METHODS: This retrospective cohort study used the Surveillance, Epidemiology, and End Results (SEER) database (2010‑2022) to identify 10,495 patients with T2N0M0 MIBC. Temporal trends in treatment modalities (RC, trimodality therapy [TMT], partial cystectomy with chemotherapy [PC + CT], etc.) were an…

The Hippo Pathway Is Dysregulated in Cancer-Associated Fibroblasts in Anti-PD-L1-Resistant Cancer.

Cancer research · 2026 · PMID 41784658

UNLABELLED: The use of immunotherapy in solid tumors has significantly improved the outcomes and quality of life for patients with cancer. However, a substantial fraction of patients remains unresponsive, highlighting the urgent need to identify mechanisms of resistance to enhance immune-centric, chemo-free treatment regimens. In this study, we investigated associations with immunotherapy resistance by integrating RNA sequencing data from 2,800 patients with bladder cancer enrolled in the IMvigor trials, focusing o…

Impact of protocolized intravesical instillation after TURBT on men's sexual quality of life:a retrospective cohort study.

Frontiers in urology · 2026 · PMID 42666825

OBJECTIVE: To determine whether protocolized intravesical gemcitabine instillation after transurethral resection of bladder tumor (TURBT) is associated with men's sexual quality of life, assessed using the Sexual Life Quality Questionnaire (SLQQ), compared with a single immediate postoperative instillation. METHODS: We conducted a retrospective cohort study of 244 men with non-muscle-invasive bladder cancer undergoing TURBT between January 2021 and May 2024. Patients received either protocolized intravesical gemcit…

Management of high-risk non-muscle invasive bladder cancer: a real-world study in North America, Europe and Japan.

Future oncology (London, England) · 2026 · PMID 42504607

INTRODUCTION: Non-muscle-invasive bladder cancer (NMIBC) accounts for approximately 75% of newly diagnosed bladder cancers and is particularly prevalent in men. Guidelines stratify patients into risk categories based on disease characteristics as patients often recur or progress to muscle-invasive disease. Most guidelines recommend transurethral resection of bladder tumor (TURBT) followed by up to 3 years of Bacillus Calmette-Guerin (BCG) therapy for high-risk (HR) patients. For very HR patients or those who recur …

The impact of high-grade complications on quality of life and psychosocial distress in the early period after radical cystectomy.

BJUI compass · 2026 · PMID 42291093

OBJECTIVES: This study aims to investigate the impact of high-grade complications (i.e., Clavien-Dindo Classification [CDC] Grade ≥III) on quality of life (QoL) and psychosocial distress (PD) in the early period after radical cystectomy (RC) and urinary diversion. PATIENTS AND METHODS: The study relied on prospectively collected data of patients undergoing 3 weeks of inpatient rehabilitation (IR) after RC and urinary diversion (ileal conduit [IC] or ileal neobladder [INB]) between 04/2018 and 12/2019. Patients were…

Severe primary organ-related complications in patients with de novo metastatic cancer: implications for prophylactic local therapy.

Clinical and translational radiation oncology · 2026 · PMID 42494656

PURPOSE: Patients with de novo metastatic cancer develop local organ-related complications leading to hospitalizations, procedures, and reduced quality of life. Prophylactic local therapy (e.g., radiotherapy) has been proposed to reduce morbidity, but the incidence and timing of severe primary organ-related events (SPOREs) remain poorly defined. We quantified the cumulative incidence and spectrum of SPOREs to inform trials of prophylactic local therapy. METHODS: We conducted a retrospective cohort study of 358 pati…

Intra-corporeal robot-assisted versus open radical cystectomy: a meta-analysis.

World journal of urology · 2026 · PMID 42525253

OBJECTIVE: To compare the safety and effectiveness between robot-assisted radical cystectomy with intracorporeal urinary diversion (iRARC) and open radical cystectomy (ORC). METHODS: We conducted this systematic review and meta-analysis of the primary outcomes of interest according to the PRISMA and AMSTAR Guidelines. Five databases were systematically searched, including Medline, PubMed, Cochrane Library, Scopus, and Web of Science. The search timeframe was set from database creation to February 2026. RESULTS: The…

Comparative efficacy of hyperthermic chemotherapy and BCG instillation in non-muscle invasive bladder cancer: a systematic review and meta-analysis.

International urology and nephrology · 2026 · PMID 41520313

OBJECTIVE: To systematically evaluate the comparative efficacy and safety of hyperthermic intravesical chemotherapy (HIVEC) versus bacillus Calmette-Guérin (BCG) instillation in patients with non-muscle-invasive bladder cancer (NMIBC). METHODS: A systematic literature search was conducted across PubMed, Embase, the Cochrane Library, and CBM from inception to June 30, 2025, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The study protocol was registered in the I…

Antibody-Drug Conjugates for Locally Advanced and Metastatic Urothelial Carcinoma: A Systematic Review and Meta-Analysis.

JAMA network open · 2026 · PMID 42223943

IMPORTANCE: Antibody-drug conjugates (ADCs), including enfortumab vedotin, disitamab vedotin, and sacituzumab govitecan, are altering the therapeutic landscape for locally advanced or metastatic urothelial carcinoma (la/mUC). Comprehensive comparative evidence evaluating their translation in the clinical setting and modifying clinical covariates is required. OBJECTIVE: To synthesize multidimensional evidence from interventional and observational settings to evaluate clinical outcomes, define the evolving therapeuti…

Perioperative Immunotherapy in Muscle-Invasive Bladder Cancer: A Systematic Review and Meta-Analysis of Neoadjuvant and Adjuvant Strategies.

Clinical oncology (Royal College of Radiologists (Great Britain)) · 2026 · PMID 42520756

AIMS: To evaluate the efficacy and safety of the perioperative immunotherapy-based regimens. MATERIALS AND METHODS: A systematic search of PubMed/MEDLINE, Embase, Scopus, and the Cochrane Central Register of Controlled Trials was performed from January 2000 to October 2025, with an updated search through June 2026. Eligible studies included randomized trials and prospective clinical studies evaluating neoadjuvant, adjuvant, or combined perioperative immunotherapy-based strategies in patients with MIBC. Outcomes inc…

Time-of-Day Immunotherapy Administration and Outcomes in Advanced Cancers: A Systematic Review and Meta-Analysis.

JAMA network open · 2026 · PMID 42084869

IMPORTANCE: Circadian rhythms affect immunity, which could affect the effectiveness of immune checkpoint inhibitor (ICI). Whether the time of ICI administration is associated with clinical outcomes in advanced cancers remains unclear. OBJECTIVE: To evaluate the association between time of day of ICI administration and oncologic outcomes in patients with advanced solid tumors. DATA SOURCES: MEDLINE (via PubMed), Embase, and Web of Science Core Collection were searched in February 2026 to identify eligible studies. S…

Blue versus white light for transurethral resection of non-muscle invasive bladder cancer.

The Cochrane database of systematic reviews · 2026 · PMID 42274003

RATIONALE: Disease recurrence and progression remain major challenges in the treatment of non-muscle invasive bladder cancer (NMIBC). Blue light-enhanced transurethral resection of bladder cancer (TURBT) is an approach to improve staging and achieve a complete resection of NMIBC. Since the first version of this review was published in 2021, new evidence on this topic has become available. OBJECTIVES: To assess the effects of blue light-enhanced TURBT compared to white light-based TURBT in the treatment of non-muscl…

FGFR3 Alterations and Nectin-4 Expression as Therapeutic Biomarkers in Bladder Cancer: A Systematic Review and Single-Arm Meta-Analysis.

International journal of molecular sciences · 2026 · PMID 42278538

Bladder cancer is a molecularly heterogeneous malignancy in which biomarker-driven therapies increasingly shape clinical management. Fibroblast growth factor receptor 3 (FGFR3) alterations and nectin-4 expression are key therapeutic targets, yet their integrated biological and clinical relevance remains unclear. A systematic search of PubMed, Scopus, and Cochrane Central was conducted from database inception to 22 February 2026 (PROSPERO: CRD420261309413). Studies reporting the prevalence of FGFR3 alterations and/o…

Incidence and Spectrum of Adverse Events With Enfortumab Vedotin Therapy in Advanced or Metastatic Urothelial Carcinoma: Evidence From a Systematic Review and Meta-Analysis.

Archivos espanoles de urologia · 2026 · PMID 42438880

BACKGROUND: Systemic treatment options for locally advanced or metastatic urothelial carcinoma (La/mUC), especially for patients resistant to chemotherapy and ineligible for immunotherapy, are a current research focus. Enfortumab vedotin (EV), an antibody-drug conjugate targeting Nectin-4, has recently been introduced, necessitating attention to its potential adverse reactions for patient safety. METHODS: Databases were searched for publications up to 12 June 2025. Clinical trials and retrospective studies investig…

Comparative efficacy and safety of open, laparoscopic, and robot-assisted radical cystectomy: a systematic review and network meta-analysis.

Journal of robotic surgery · 2026 · PMID 42213216

The most appropriate surgical strategy for radical cystectomy in bladder cancer remains to be established. This study performed a network meta-analysis of randomized controlled trials to evaluate open, laparoscopic, and robot-assisted approaches. Outcomes were systematically classified into intraoperative metrics, postoperative recovery, perioperative safety, and oncological efficacy. A random effects model was employed, and treatment hierarchy was determined using the surface under the cumulative ranking curve. El…

Clinical complete response as a surrogate for pathological response in bladder cancer: a systematic review and meta-analysis.

BJU international · 2026 · PMID 41839747

OBJECTIVE: To evaluate the concordance between clinical complete response (cCR) and pathological complete response (pCR) in muscle-invasive bladder cancer (MIBC) to assess the surrogacy and prognostic value of cCR for guiding bladder-sparing strategies. METHODS: In this prospectively registered systematic review and meta-analysis (CRD420251066540), we searched MEDLINE, EMBASE, and Web of Science in June 2025 for studies reporting clinical and pathological complete response rates in patients with MIBC undergoing neo…

Efficacy and safety of combination versus single-agent immunotherapy for BCG-unresponsive non-muscle-invasive bladder cancer.

Frontiers in immunology · 2026 · PMID 42582256

BACKGROUND: Bacillus Calmette-Guérin (BCG) is the standard adjuvant therapy for high-risk non-muscle-invasive bladder cancer (NMIBC); however, a substantial proportion of patients develop BCG-unresponsive disease with limited bladder-preserving options. The objective of this study was to determine whether combination immunotherapy provides superior clinical efficacy and safety compared with single-agent immunotherapy for patients with BCG-unresponsive NMIBC. METHODS: We conducted a systematic analysis of studies re…

ctDNA-guided or ctDNA-stratified adjuvant immunotherapy compared with observation or placebo after radical surgery for muscle-invasive urothelial carcinoma: a GRADE-assessed systematic review and meta-analysis.

World journal of urology · 2026 · PMID 42661024

BACKGROUND: Adjuvant immunotherapy after radical surgery for muscle-invasive urothelial carcinoma has produced heterogeneous trial-level results, partly because clinicopathological risk factors do not completely identify patients with molecular residual disease (MRD). Circulating tumor DNA may refine postoperative treatment selection by distinguishing patients who are most likely to benefit from immune checkpoint inhibition from those who may experience unnecessary toxicity. METHODS: This systematic review and meta…

A Systematic Review of Intracavitary Therapies for Upper Tract Urothelial Carcinoma.

European urology oncology · 2026 · PMID 41241654

BACKGROUND AND OBJECTIVE: Radical nephroureterectomy is the standard of care for management of upper tract urothelial carcinoma (UTUC), but treatment-associated morbidity is not uncommon. Intracavitary therapy has emerged as a less invasive alternative for selected cases, particularly carcinoma in situ (CIS) and low-grade papillary tumors. We conducted a systematic review to evaluate the outcomes, recurrence rates, and adverse events associated with intracavitary therapy (immunotherapy or chemoablation) for UTUC. M…

Comparative efficacy of perioperative systemic therapies for muscle-invasive bladder cancer: a network meta-analysis of randomized trials.

ESMO open · 2026 · PMID 42485700

BACKGROUND: The perioperative treatment landscape of muscle-invasive bladder cancer (MIBC) is rapidly evolving with the introduction of immune checkpoint inhibitor (ICI)- and antibody-drug conjugate (ADC)-based strategies. However, direct randomized comparisons among contemporary regimens are lacking, limiting the interpretation and positioning of treatments. We aimed to compare the efficacy of perioperative systemic treatment strategies for MIBC with a network meta-analysis (NMA) of randomized controlled trials (R…

Dietary Fatty Acids and Bladder Cancer Risk: Insights from the PLCO Cancer Screening Trial.

Nutrition and cancer · 2025 · PMID 40237627

This study aimed to evaluate the relationship between the consumption of different dietary fatty acids and the risk of bladder cancer. A quantitative analysis was conducted using data from the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial, which included 101,731 participants. The Cox proportional hazards model was used to calculate hazard ratios (HR) and 95% confidence intervals (CI) for bladder cancer risk in relation to dietary fatty acid intake. During a median follow-up of 11.3 years, 86…

Indirect Comparison of Neoadjuvant Treatment Strategies for Muscle-Invasive Bladder Cancer: ddMVAC and Perioperative Durvalumab-Gemcitabine-Cisplatin Versus Gemcitabine-Cisplatin: A Systematic Review and Network Meta-Analysis of Randomised Controlled Trials.

International journal of cancer · 2026 · PMID 42050770

For cisplatin-eligible patients with muscle-invasive bladder cancer (MIBC) undergoing radical cystectomy (RC), neoadjuvant cisplatin-based chemotherapy (NAC) is standard of care. More intensive regimens such as dose-dense methotrexate, vinblastine, doxorubicin and cisplatin (ddMVAC) and chemoimmunotherapy with durvalumab plus gemcitabine-cisplatin (D-GC) have shown superior outcomes. This network meta-analysis (NMA) compares the efficacy of ddMVAC, D-GC and GC and explores the efficacy thresholds for emerging thera…

Antidiabetic medications and the risk of bladder cancer in patients with diabetes mellitus: A systematic review and meta-analysis.

Urologic oncology · 2026 · PMID 42314323

Bladder cancer (BC) is the most common malignancy of the urinary system worldwide. Type 2 diabetes mellitus (T2DM) and its treatments may influence BC risk, but existing evidence is conflicting. This study aimed to systematically evaluate the association between various classes of antidiabetic medications (ADMs) and BC risk in patients with T2DM. We conducted a systematic review and meta-analysis following PRISMA guidelines, searching multiple databases up to September 30, 2025. Cohort studies, case-control studies…

Adjuvant PD-1 Inhibitors After Radical Surgery for High-Risk Muscle-Invasive Urothelial Carcinoma: A Systematic Review and Meta-Analysis of Phase 3 Trials.

Urology practice · 2026 · PMID 41665515

INTRODUCTION: Patients with high-risk muscle-invasive bladder cancer (MIBC) remain at substantial risk of disease recurrence. Randomized phase 3 trials have evaluated adjuvant programmed cell death 1 (PD-1) inhibitors in this setting, but the magnitude and consistency of benefit across patient subgroups remain incompletely defined. METHODS: We performed a systematic review and meta-analysis of randomized phase 3 trials comparing adjuvant PD-1 inhibitors with placebo or observation in patients with resected high-ris…

Tranexamic acid in radical cystectomy: a systematic review and meta-analysis of efficacy and safety.

World journal of urology · 2025 · PMID 40965659

PURPOSE: Radical cystectomy (RC) is a high-risk procedure, associated with significant bleeding and high risk of perioperative blood transfusion (PBT), which may limit clinical and oncological outcomes. Tranexamic acid (TXA), an antifibrinolytic agent, effectively reduces bleeding in various surgical settings; however, its role in RC remains understudied. This systematic review and meta-analysis evaluates the efficacy and safety of TXA in RC patients. METHODS: A systematic search of CENTRAL, PubMed, Embase, and Web…

Immune-Enhancing Nutrition and Outcomes After Radical Cystectomy: A Randomized Clinical Trial.

JAMA network open · 2026 · PMID 42475098

IMPORTANCE: Radical cystectomy for bladder cancer is associated with high complication rates. Evidence supporting perioperative specialized immunonutrition for reducing complications is limited. OBJECTIVE: To determine whether perioperative specialized immunonutrition reduces 30-day complications compared with standard oral nutrition support among adults undergoing radical cystectomy. DESIGN, SETTING, AND PARTICIPANTS: This multicenter, randomized, double-blind, phase 3 clinical trial (SWOG S1600) conducted at 13 U…

Bladder Adjuvant Radiotherapy: Phase III Multicenter Randomized Controlled Trial of Adjuvant Radiotherapy or Observation for Postcystectomy Muscle-Invasive Bladder Cancer.

Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2026 · PMID 42166701

PURPOSE: To report the primary analysis of a multicenter, phase III randomized trial of adjuvant radiotherapy (RT) after chemotherapy and radical cystectomy (RC) in patients with high-risk muscle-invasive bladder cancer (MIBC). METHODS: Patients with nonmetastatic urothelial MIBC at high risk after RC (any one of: T3-4, N1-3, margin positive, ≤10 nodes dissected) were randomly assigned 1:1 to adjuvant RT or observation (Obs), stratified by nodal involvement (yes/no) and chemotherapy (neoadjuvant/adjuvant/none). Sto…

Neoadjuvant Durvalumab ± Tremelimumab in Combination With Dose-Dense Methotrexate, Vinblastine, Doxorubicin, and Cisplatin in Muscle-Invasive Bladder Carcinoma: Results of the Phase I/II NEMIO Study.

Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2026 · PMID 42190158

PURPOSE: To evaluate the efficacy and safety of neoadjuvant dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin (ddMVAC) combined with durvalumab ± tremelimumab in patients with muscle-invasive bladder cancer (MIBC). METHODS: NEMIO (ClinicalTrials.gov identifier: NCT03549715) is a multicenter, randomized, noncomparative phase II trial in cT2-T4a N0-1 cisplatin-eligible MIBC planned for radical cystectomy (RC). Patients received ddMVAC (cisplatin 70 mg/m2, methotrexate 30 mg/m2, doxorubicin 30 mg/m2, an…

Prospective comparative evaluation of clinical efficacy and safety of Intravesical gemcitabine-docetaxel versus BCG in adjuvant management of BCG-naive non-muscle invasive urothelial bladder cancer in Indian population.

International urology and nephrology · 2026 · PMID 41843343

BACKGROUND: Intravesical Bacillus Calmette-Guérin (BCG) is the standard adjuvant therapy for intermediate/high-risk non-muscle-invasive bladder cancer (NMIBC) but is limited by failure, toxicity, and global supply constraints. Sequential Intravesical gemcitabine-docetaxel (Gem/Doce) can offer a rational chemotherapy alternative. METHODS: In this prospective randomized, parallel-arm interventional study comparing efficacy and safety of Gem/Doce versus BCG in BCG-naïve intermediate/high-risk NMIBC, patients aged 18-8…

Atezolizumab in Combination With Gemcitabine and Cisplatin as First-Line Treatment in Metastatic Urothelial Cancer: A Randomized Phase II Study of Two Alternative Dosing Schedules.

Clinical genitourinary cancer · 2026 · PMID 42217273

BACKGROUND: The potential impact of treatment sequencing in chemoimmunotherapy combinations remains underexplored. We evaluated 2 alternative dosing schedules of chemotherapy (cisplatin and gemcitabine [GC]) and an immune checkpoint inhibitor (CPI; atezolizumab [A]) for metastatic urothelial carcinoma (mUC). METHODS: This multicenter phase II study randomized cisplatin-eligible patients with previously untreated mUC in a 1:1 ratio. The chemo-first schedule included 2 cycles of GC, followed by 4 cycles of GC + A and…

Image directed redesign of bladder cancer treatment pathways: the BladderPath RCT.

Health technology assessment (Winchester, England) · 2024 · PMID 39246267

BACKGROUND: Transurethral resection of bladder tumour has been the mainstay of bladder cancer staging for > 60 years. Staging inaccuracies are commonplace, leading to delayed treatment of muscle-invasive bladder cancer. Multiparametric magnetic resonance imaging offers rapid, accurate and non-invasive staging of muscle-invasive bladder cancer, potentially reducing delays to radical treatment. OBJECTIVES: To assess the feasibility and efficacy of the introducing multiparametric magnetic resonance imaging ahead of tr…

Perioperative Immunotherapy in Muscle-Invasive Bladder Cancer: A Systematic Review and Meta-Analysis of Neoadjuvant and Adjuvant Strategies.

Clinical oncology (Royal College of Radiologists (Great Britain)) · 2026 · PMID 42520756

AIMS: To evaluate the efficacy and safety of the perioperative immunotherapy-based regimens. MATERIALS AND METHODS: A systematic search of PubMed/MEDLINE, Embase, Scopus, and the Cochrane Central Register of Controlled Trials was performed from January 2000 to October 2025, with an updated search through June 2026. Eligible studies included randomized trials and prospective clinical studies evaluating neoadjuvant, adjuvant, or combined perioperative immunotherapy-based strategies in patients with MIBC. Outcomes inc…

ctDNA-guided or ctDNA-stratified adjuvant immunotherapy compared with observation or placebo after radical surgery for muscle-invasive urothelial carcinoma: a GRADE-assessed systematic review and meta-analysis.

World journal of urology · 2026 · PMID 42661024

BACKGROUND: Adjuvant immunotherapy after radical surgery for muscle-invasive urothelial carcinoma has produced heterogeneous trial-level results, partly because clinicopathological risk factors do not completely identify patients with molecular residual disease (MRD). Circulating tumor DNA may refine postoperative treatment selection by distinguishing patients who are most likely to benefit from immune checkpoint inhibition from those who may experience unnecessary toxicity. METHODS: This systematic review and meta…

A Systematic Review of Intracavitary Therapies for Upper Tract Urothelial Carcinoma.

European urology oncology · 2026 · PMID 41241654

BACKGROUND AND OBJECTIVE: Radical nephroureterectomy is the standard of care for management of upper tract urothelial carcinoma (UTUC), but treatment-associated morbidity is not uncommon. Intracavitary therapy has emerged as a less invasive alternative for selected cases, particularly carcinoma in situ (CIS) and low-grade papillary tumors. We conducted a systematic review to evaluate the outcomes, recurrence rates, and adverse events associated with intracavitary therapy (immunotherapy or chemoablation) for UTUC. M…

Role of Postoperative Radiation Therapy After Radical Cystectomy for Bladder Cancer: A Systematic Review and Meta-Analysis.

Advances in radiation oncology · 2026 · PMID 42382432

PURPOSE: Radical cystectomy with neoadjuvant cisplatin-based chemotherapy is the standard of care for muscle-invasive bladder cancer (MIBC). However, recurrence remains common. Postoperative radiation therapy (PORT) has been explored to improve locoregional control and survival, but evidence remains inconclusive. This systematic review and meta-analysis assessed the role of PORT in MIBC. METHODS AND MATERIALS: PubMed, Embase, and Cochrane were searched through March 2025 (CRD42025632052). Eligible studies included …

Hyperthermic Intravesical Chemotherapy as a Bladder-Sparing Alternative to BCG in the Management of Non-Muscle-Invasive Bladder Cancer: A Systematic Review of Oncological Outcomes in the Era of BCG Shortage.

Journal of clinical medicine · 2026 · PMID 42652756

Background/Objectives: The ongoing Bacillus Calmette-Guérin (BCG) shortage, treatment intolerance, and BCG-unresponsive disease necessitate bladder-sparing alternatives for non-muscle-invasive bladder cancer (NMIBC). We reviewed the clinical evidence for hyperthermic intravesical chemotherapy (HIVEC). Methods: PubMed and PubMed Central were searched from inception to 15 March 2026 (updated 10 July 2026) for primary studies of device-assisted HIVEC in NMIBC. Studies reporting recurrence-free survival (RFS), progress…

Concurrent radiosensitising regimens for bladder-preserving radiotherapy in non-metastatic muscle-invasive bladder cancer: a systematic review and structured evidence synthesis with exploratory network meta-analysis.

International urology and nephrology · 2026 · PMID 42645666

PURPOSE: To synthesise randomised comparative and prospective evidence on concurrent radiosensitising regimens used with bladder-preserving radiotherapy for non-metastatic muscle-invasive bladder cancer and determine whether the available evidence supports a regimen hierarchy. METHODS: PubMed/MEDLINE, Embase, Web of Science Core Collection, and Cochrane CENTRAL were searched till May 14, 2026. Randomised trials formed the comparative evidence backbone. A frequentist random-effects network meta-analysis was restrict…

Patient-Reported Outcome Instruments in Non-Muscle-Invasive Bladder Cancer (NMIBC): A Systematic Review.

Oncology and therapy · 2026 · PMID 42642612

INTRODUCTION: Non-muscle-invasive bladder cancer (NMIBC) is a chronic and recurrent condition requiring repeated intravesical treatments and lifelong surveillance, imposing a substantial burden on patients. Patient-reported outcomes (PROs) are increasingly required by regulatory bodies and HTA bodies to capture treatment impact from the patient perspective, yet no consensus on the optimal PRO instruments for use in NMIBC trials exists. This systematic review evaluated PRO instruments used in NMIBC and appraised the…

Dietary Fatty Acids and Bladder Cancer Risk: Insights from the PLCO Cancer Screening Trial.

Nutrition and cancer · 2025 · PMID 40237627

This study aimed to evaluate the relationship between the consumption of different dietary fatty acids and the risk of bladder cancer. A quantitative analysis was conducted using data from the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial, which included 101,731 participants. The Cox proportional hazards model was used to calculate hazard ratios (HR) and 95% confidence intervals (CI) for bladder cancer risk in relation to dietary fatty acid intake. During a median follow-up of 11.3 years, 86…

Health risk assessment of inorganic arsenic: an umbrella review.

Reviews on environmental health · 2026 · PMID 42494104

Inorganic arsenic (iAs) is a toxic environmental pollutant linked to serious health risks, prompting global regulatory efforts. This study identifies major health conditions associated with iAs exposure using text network analysis, and assesses health risk assessments through an umbrella review and dose-response analysis. It synthesizes previous systematic reviews to offer a broader perspective on iAs-related health effects. An optimized text network analysis-based search strategy was applied across multiple databa…

Antidiabetic medications and the risk of bladder cancer in patients with diabetes mellitus: A systematic review and meta-analysis.

Urologic oncology · 2026 · PMID 42314323

Bladder cancer (BC) is the most common malignancy of the urinary system worldwide. Type 2 diabetes mellitus (T2DM) and its treatments may influence BC risk, but existing evidence is conflicting. This study aimed to systematically evaluate the association between various classes of antidiabetic medications (ADMs) and BC risk in patients with T2DM. We conducted a systematic review and meta-analysis following PRISMA guidelines, searching multiple databases up to September 30, 2025. Cohort studies, case-control studies…

Economic evaluations of neoadjuvant drug regimens in cancer: a systematic review.

Frontiers in public health · 2026 · PMID 42688252

BACKGROUND: Neoadjuvant drug therapy has become an important component of multidisciplinary cancer treatment, but newer targeted, immunotherapy-based, and multi-agent regimens are often associated with higher costs and uncertainty regarding long-term economic value. This systematic review evaluates the economic evidence for neoadjuvant drug regimens in cancer and summarizes key cost-effectiveness findings across tumor types and healthcare settings. METHODS: We systematically searched PubMed, Embase, and the Cochran…

Antibiotic exposure and cancer risk: an umbrella review elucidating the direction of risk across 14 malignancies.

Journal of public health (Oxford, England) · 2026 · PMID 42361054

BACKGROUND: Antibiotics are among the most frequently prescribed medications worldwide. However, previous studies have yielded inconsistent findings regarding the association between antibiotic exposure and the risk of various cancers, and the credibility of the available evidence remains uncertain. METHODS: We conducted an umbrella review based on published meta-analyses and systematic reviews to evaluate the association between past or current antibiotic exposure and cancer risk. PubMed, Embase, Cochrane Library,…

Environmental Nonessential Element Exposure and Urologic Cancer: A Systematic Review and Meta-Analysis.

JAMA network open · 2026 · PMID 42172026

IMPORTANCE: Urologic cancers have been linked to nonessential chemical elements with no known beneficial role in the body, though associations between low-level environmental exposure and urologic cancer risk are poorly understood. OBJECTIVE: To systematically synthesize epidemiologic evidence on the association between environmental exposure to nonessential elements and risk of urologic cancers. DATA SOURCES: English- and Chinese-language databases, including PubMed, Embase, Web of Science, Scopus, Cumulated Index…

Immune-Enhancing Nutrition and Outcomes After Radical Cystectomy: A Randomized Clinical Trial.

JAMA network open · 2026 · PMID 42475098

IMPORTANCE: Radical cystectomy for bladder cancer is associated with high complication rates. Evidence supporting perioperative specialized immunonutrition for reducing complications is limited. OBJECTIVE: To determine whether perioperative specialized immunonutrition reduces 30-day complications compared with standard oral nutrition support among adults undergoing radical cystectomy. DESIGN, SETTING, AND PARTICIPANTS: This multicenter, randomized, double-blind, phase 3 clinical trial (SWOG S1600) conducted at 13 U…

Prospective comparative evaluation of clinical efficacy and safety of Intravesical gemcitabine-docetaxel versus BCG in adjuvant management of BCG-naive non-muscle invasive urothelial bladder cancer in Indian population.

International urology and nephrology · 2026 · PMID 41843343

BACKGROUND: Intravesical Bacillus Calmette-Guérin (BCG) is the standard adjuvant therapy for intermediate/high-risk non-muscle-invasive bladder cancer (NMIBC) but is limited by failure, toxicity, and global supply constraints. Sequential Intravesical gemcitabine-docetaxel (Gem/Doce) can offer a rational chemotherapy alternative. METHODS: In this prospective randomized, parallel-arm interventional study comparing efficacy and safety of Gem/Doce versus BCG in BCG-naïve intermediate/high-risk NMIBC, patients aged 18-8…

Intravesical mitomycin-C administered immediately before transurethral resection of bladder tumor in non-muscle-invasive bladder cancer: Clinical outcomes and molecular predictors from over 3 years of extended follow-up in a phase II trial.

Investigative and clinical urology · 2026 · PMID 42683856

PURPOSE: To evaluate the long-term outcomes and molecular correlates of response after immediate preoperative intravesical chemotherapy (IPeIC) with mitomycin-C (MMC) in patients with non-muscle-invasive bladder cancer (NMIBC). MATERIALS AND METHODS: In this single-center, open-label, randomized phase II trial, 33 patients received two split doses of IPeIC/MMC (40 mg/20 mL), whereas 38 patients underwent transurethral resection of bladder tumor (TURBT) alone. The primary endpoint was 3-year recurrence-free survival…

A phase Ib/II, open-label, multicenter, randomized umbrella study evaluating the combination of atezolizumab with sacituzumab govitecan in patients with locally advanced or metastatic urothelial carcinoma and previously treated with a platinum-based treatment regimen (MORPHEUS-Urothelial Carcinoma).

ESMO open · 2026 · PMID 42418909

BACKGROUND: MORPHEUS-UC (NCT03869190) is a signal-seeking, global, phase Ib/II, open-label, multicenter, randomized, umbrella study in patients with platinum-treated locally advanced or metastatic urothelial carcinoma (mUC). Patients were randomly assigned to one of seven atezolizumab (anti-programmed death-ligand 1)-based treatment combinations or atezolizumab monotherapy. We report efficacy and safety results for atezolizumab + sacituzumab govitecan (trophoblast cell surface antigen-2-directed antibody conjugate)…

Bladder preservation with disitamab vedotin plus PD-1 inhibitors and local intensification in muscle-invasive bladder cancer: a single-center retrospective cohort of 81 patients.

International urology and nephrology · 2026 · PMID 42663909

PURPOSE: To evaluate the efficacy and safety of disitamab vedotin (DV) plus a PD-1 inhibitor combined with different local intensification strategies for the bladder-preserving management of muscle-invasive bladder cancer (MIBC). METHODS: This single-center retrospective cohort study enrolled patients with MIBC who underwent maximal transurethral resection of bladder tumor (TURBT), followed by DV plus a PD-1 inhibitor between January 1, 2023, and September 30, 2025. According to the local intensification strategy, …

Robotic-assisted intracorporeal radical cystectomy with modified ileal conduit reduces ureteroileal anastomotic stenosis risk: a comparative study with laparoscopic surgery.

Annals of medicine · 2026 · PMID 42525819

BACKGROUND: This study aims to evaluate the clinical efficacy of an innovative robot-assisted totally intracorporeal antecolic modified ileal conduit procedure (robotic group) versus laparoscopic surgery (laparoscopic group) in bladder cancer patients, providing evidence for optimizing urinary diversion strategies and reducing associated complications. METHODS: From Jan 2023 to Oct 2025, 69 patients undergoing total cystectomy by one surgeon were enrolled; 23 received robotic surgery (KangDuo SR2000) and 46 laparos…

Photodynamic therapy: research progress and paradigm evolution from mechanism innovation to clinical breakthrough in cancers.

Medical gas research · 2026 · PMID 42157432

FactsPhotodynamic therapy (PDT) is a minimally invasive anticancer modality based on the light-mediated activation of photosensitizers to generate reactive oxygen species and induce tumor cell death.PDT has demonstrated clinical efficacy in treating various tumor types, including esophageal cancer, gastric cancer, lung cancer, skin cancer, bladder cancer, cervical cancer, ovarian cancer, and glioblastoma.The antitumor effects of PDT are mediated not only by direct tumor cell killing but also by vascular damage, imm…

Fluorescence-guided local therapy for bladder and upper urinary tract cancer: a narrative review.

Photodiagnosis and photodynamic therapy · 2026 · PMID 42617714

Fluorescence-guided surgery using photodynamic diagnosis (PDD) has reshaped the local management of urothelial cancer by overcoming the limitations of white light endoscopy. Leveraging tumor-selective protoporphyrin IX accumulation after 5-aminolevulinic acid (ALA) or hexaminolevulinate (HAL) administration, PDD reliably highlights flat and subtle lesions that are frequently missed under white light, particularly carcinoma in situ. This narrative review synthesized randomized trials, patient-level meta-analyses, mu…

Therapeutic landscape of upper tract urothelial carcinoma: Intraluminal agents, perioperative chemotherapy, and immunotherapy.

Urologic oncology · 2026 · PMID 42660692

BACKGROUND: Upper tract urothelial carcinoma (UTUC) is an uncommon genitourinary malignancy with distinct anatomical and clinical challenges. Historically, treatment strategies have been extrapolated from bladder cancer, leaving gaps in evidence for UTUC-specific management. Recent advances in intraluminal drug delivery and systemic therapy have presented new options across localized, locally advanced, and metastatic disease. METHODS: We reviewed prospective trials, retrospective cohort studies, and ongoing studies…

Efficacy and Safety of Disitamab Vedotin Combined with Gemcitabine as Neoadjuvant Therapy in Muscle-invasive Bladder Cancer: An Open-label, Multicenter, Single-arm, Phase 2 Trial.

European urology · 2026 · PMID 41193372

There are barriers to the clinical use of cisplatin-based neoadjuvant regimens in muscle-invasive bladder cancer (MIBC), especially for patients with renal dysfunction, hearing loss, heart diseases, or other severe comorbidities. Favorable efficacy and safety of disitamab vedotin (DV), an antibody-drug conjugate targeting HER2, have recently been demonstrated in urothelial carcinoma. We explored neoadjuvant gemcitabine combined with RC48 in the MIBC setting. Initially, 26 patients with clinical stage T2-4a Nx M0 MI…

Immune Checkpoint Inhibitor-Associated Uveitis: Insights From Comparative Analyses Across Malignancies and Drug Classes.

American journal of ophthalmology · 2026 · PMID 42229563

PURPOSE: Understanding how the risk of immune checkpoint inhibitor (ICI)-associated noninfectious uveitis (NIU) differs by malignancy and drug class may help understand its pathophysiology and guide targeted ophthalmic surveillance. This study aims to evaluate the comparative risk of ICI-associated NIU across different malignancies and drug classes. DESIGN: Retrospective, multicenter clinical cohort study. SUBJECTS: Adults with metastatic melanoma, lung cancer, renal cell carcinoma (RCC), urothelial carcinoma, hepa…

Long-term follow-up of a phase 1/2 trial of anti-GDF-15 antibody visugromab plus anti-PD-1 antibody nivolumab in anti-PD-1/-L1 relapsed/refractory solid tumors.

Journal of hematology & oncology · 2026 · PMID 42426863

BACKGROUND: Resistance to anti-PD-1/PD-L1 therapy is a major unmet need. Growth Differentiation Factor 15 (GDF-15) has been identified as a key resistance factor for anti-PD-1/PD-L1 immunotherapy. Visugromab, a neutralizing anti-GDF-15 antibody, plus the anti-PD-1 antibody nivolumab (V+N) was evaluated in the first-in-human phase 1/2a GDFATHER-01 trial in heavily pretreated participants with locally advanced/metastatic non-squamous non-small-cell lung cancer (nsq NSCLC), urothelial carcinoma (UC), or hepatocellular…

Dietary Fatty Acids and Bladder Cancer Risk: Insights from the PLCO Cancer Screening Trial.

Nutrition and cancer · 2025 · PMID 40237627

This study aimed to evaluate the relationship between the consumption of different dietary fatty acids and the risk of bladder cancer. A quantitative analysis was conducted using data from the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial, which included 101,731 participants. The Cox proportional hazards model was used to calculate hazard ratios (HR) and 95% confidence intervals (CI) for bladder cancer risk in relation to dietary fatty acid intake. During a median follow-up of 11.3 years, 86…

Clinical effectiveness of a multitarget urine DNA test for urothelial carcinoma detection: a double-blinded, multicenter, prospective trial.

Molecular cancer · 2024 · PMID 38504268

Urine-based testing is promising for noninvasive diagnosis of urothelial carcinoma (UC) but has suboptimal sensitivity for early-stage tumors. Herein, we developed a multitarget urine tumor DNA test, UI-Seek, for UC detection and evaluated its clinical feasibility. The prediction model was developed in a retrospective cohort (n = 382), integrating assays for FGFR3 and TERT mutations and aberrant ONECUT2 and VIM methylation to generate a UC-score. The test performance was validated in a double-blinded, multicenter, …

Adjuvant nivolumab versus placebo for high-risk muscle-invasive urothelial carcinoma: 5-year efficacy and ctDNA results from CheckMate 274.

Annals of oncology : official journal of the European Society for Medical Oncology · 2026 · PMID 41110694

BACKGROUND: Despite surgery, recurrence rates remain high in muscle-invasive urothelial carcinoma (MIUC). The phase III randomized, double-blind, multicenter CheckMate 274 trial comparing adjuvant nivolumab versus placebo in patients with high-risk MIUC after radical surgery demonstrated that adjuvant nivolumab improved disease-free survival (DFS) versus placebo. We report results with 5-year minimum follow-up including exploratory analyses of circulating tumor DNA (ctDNA). PATIENTS AND METHODS: Eligible patients h…

Long-term Results from the LEA Randomized Trial: Extended Versus Standard Lymph Node Dissection in Patients with Bladder Cancer Undergoing Radical Cystectomy.

European urology · 2025 · PMID 40967930

The extent of lymph node dissection (LND) at the time of radical cystectomy (RC) for bladder cancer (BC) may affect oncologic outcomes. We present updated long-term data from a prospective, multicenter, phase 3 trial involving patients with locally resectable, high-risk T1 grade 3 or muscle-invasive urothelial BC (T2-T4a M0) without neoadjuvant treatment (trial LEA AUO AB 25/02; NCT01215071). A total of 401 patients were randomly assigned 1:1 to either standard LND (sLND: obturator, internal, and external iliac nod…

Comparison of Complication and Readmission Rates Between Robot-Assisted and Open Radical Cystectomy: Results From the Randomized RAZOR Clinical Trial.

The Journal of urology · 2025 · PMID 40080805

PURPOSE: We assessed differences in complications and readmissions between robot-assisted radical cystectomy (RARC) and open radical cystectomy (ORC). MATERIALS AND METHODS: This study uses data from the per-protocol population of the Randomized Robotic-Assisted vs Open Radical Cystectomy (RAZOR) study, a multicenter, open-label, phase 3, noninferiority clinical trial. RAZOR enrolled across 15 academic medical centers in the United States between 2011 and 2014. The median follow-up was 2 years. Complications up to …

Neoadjuvant Durvalumab ± Tremelimumab in Combination With Dose-Dense Methotrexate, Vinblastine, Doxorubicin, and Cisplatin in Muscle-Invasive Bladder Carcinoma: Results of the Phase I/II NEMIO Study.

Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2026 · PMID 42190158

PURPOSE: To evaluate the efficacy and safety of neoadjuvant dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin (ddMVAC) combined with durvalumab ± tremelimumab in patients with muscle-invasive bladder cancer (MIBC). METHODS: NEMIO (ClinicalTrials.gov identifier: NCT03549715) is a multicenter, randomized, noncomparative phase II trial in cT2-T4a N0-1 cisplatin-eligible MIBC planned for radical cystectomy (RC). Patients received ddMVAC (cisplatin 70 mg/m2, methotrexate 30 mg/m2, doxorubicin 30 mg/m2, an…

The long-term impact of single intraoperative instillation of pirarubicin after radical nephroureterectomy on local and systemic cancer control: a prospective, multicenter, randomized trial.

World journal of urology · 2025 · PMID 40080123

PURPOSE: Although the preventive effect against intravesical recurrence (IVR) has been established for single instillation of chemotherapy during or after radical surgery of upper urinary tract urothelial carcinoma (UTUC), there has been no research on the long-term outcome. This study aims to investigate the IVR and long-term survival outcome of a single intraoperative instillation of pirarubicin during radical nephroureterectomy (RNU). METHODS: In this prospective, multicenter, randomized trial, 97 patients under…

Surgical outcomes after neoadjuvant avelumab with or without chemotherapy for Muscle-Invasive bladder cancer: a Post-Hoc analysis of the aura trial (Oncodistinct-004).

World journal of urology · 2026 · PMID 41528535

PURPOSE: Neoadjuvant chemo-immunotherapy is emerging as promising strategy in muscle-invasive bladder cancer (MIBC), yet its perioperative safety remains understudied. This post-hoc analysis of the AURA phase-II trial assesses surgical outcomes following neoadjuvant avelumab with or without chemotherapy. METHODS: We analyzed 88 patients with localized MIBC from the phase 2 multicenter AURA trial (NCT03674424) who underwent radical cystectomy after receiving either avelumab monotherapy (n = 22) or chemo-immunotherap…

ALBAN (GETUG-AFU 37): a phase III, randomized, open-label international trial of intravenous atezolizumab and intravesical Bacillus Calmette-Guérin (BCG) versus BCG alone in BCG-naive high-risk, non-muscle-invasive bladder cancer (NMIBC).

Annals of oncology : official journal of the European Society for Medical Oncology · 2026 · PMID 41110692

BACKGROUND: Standard treatment of high-risk non-muscle-invasive bladder cancer (NMIBC) after transurethral resection of bladder tumor is intravesical instillation with Bacillus Calmette-Guérin (BCG) (induction and maintenance regimens); however, BCG therapy still fails in 30%-40% of patients. Prior studies suggest that programmed death-ligand 1 (PD-L1) expression and alterations in immune infiltration might be associated with BCG failure. PATIENTS AND METHODS: The ALBAN trial is an international, 1 : 1 randomized, …

An international multicentre randomised controlled trial of en bloc resection of bladder tumour vs conventional transurethral resection of bladder tumour: first results of the en bloc resection of urothelium carcinoma of the bladder (EBRUC) II trial.

BJU international · 2025 · PMID 39462182

OBJECTIVES: To determine the safety and oncological advantages of en bloc resection of bladder tumour (ERBT) vs conventional transurethral resection of bladder tumour (cTURBT) in terms of resection quality, staging quality, and safety. PATIENTS AND METHODS: We conducted a single-blinded randomised controlled trial at seven European hospitals with the following inclusion criteria: first diagnosis of non-muscle-invasive bladder cancer, no singular carcinoma in situ, and tumour size >4.3 mm. Patients were randomised i…

ctDNA-Guided Adjuvant Atezolizumab in Muscle-Invasive Bladder Cancer.

The New England journal of medicine · 2025 · PMID 41124204

BACKGROUND: Patients with muscle-invasive bladder cancer have varied outcomes after cystectomy. Circulating tumor DNA (ctDNA)-based detection of molecular residual disease may identify patients at high risk for recurrence after cystectomy who can benefit from adjuvant immunotherapy, thus sparing patients at lower risk from unnecessary treatment burden. METHODS: In a phase 3, double-blind, randomized trial, we used serial ctDNA testing to monitor (for up to 1 year) patients with muscle-invasive bladder cancer and no…

Image directed redesign of bladder cancer treatment pathways: the BladderPath RCT.

Health technology assessment (Winchester, England) · 2024 · PMID 39246267

BACKGROUND: Transurethral resection of bladder tumour has been the mainstay of bladder cancer staging for > 60 years. Staging inaccuracies are commonplace, leading to delayed treatment of muscle-invasive bladder cancer. Multiparametric magnetic resonance imaging offers rapid, accurate and non-invasive staging of muscle-invasive bladder cancer, potentially reducing delays to radical treatment. OBJECTIVES: To assess the feasibility and efficacy of the introducing multiparametric magnetic resonance imaging ahead of tr…

Active Surveillance Versus Intravesical Bacillus Calmette-Guérin for High-grade T1 Bladder Cancer with Negative Second Transurethral Resection: The Randomized Noninferiority Phase 3 JCOG1019 Trial.

European urology · 2026 · PMID 41571573

BACKGROUND AND OBJECTIVE: We evaluated the noninferiority of active surveillance (AS) in comparison to intravesical bacillus Calmette-Guérin (BCG) in terms of recurrence and progression for patients with high-grade T1 (HG T1) bladder cancer at initial transurethral resection of the bladder (TURB) and no residual tumor at second TURB. METHODS: After initial evaluation, participants diagnosed with HG T1 bladder cancer who had undergone complete eradication of visible tumors underwent a second TURB. Those with specime…

Comparison of quality of life and sexual function after ileal vs. sigmoid orthotopic neobladder reconstruction following nerves, vas deferens, and seminal vesicle-sparing radical cystectomy: A prospective randomized study.

Urologic oncology · 2026 · PMID 42217279

INTRODUCTION: Radical cystectomy with orthotopic urinary diversion is a standard treatment for muscle-invasive bladder cancer. However, the impact of different bowel segments used for neobladder reconstruction on postoperative quality of life and sexual function remains underexplored. This prospective randomized study compared the outcomes of orthotopic ileal neobladders (INB) and sigmoid neobladders following nerve-sparing, vas deferens-sparing, seminal vesicle-sparing, and partial prostate-sparing radical cystect…

Ureteroenteric strictures following retrosigmoid vs. conventional ileal conduit - The MOSAIC study (The DaBlaCa-16 study).

BJU international · 2025 · PMID 40936067

OBJECTIVES: To evaluate the rate of left-sided ureteroenteric strictures (UES) following robot-assisted radical cystectomy (RARC) with a retrosigmoid ileal conduit compared to a conventional ileal conduit in a randomised controlled trial (RCT). PATIENTS AND METHODS: This multicentre, RCT included 303 patients undergoing RARC between May 2020 and August 2022. Patients were randomised to receive either a retrosigmoid or a conventional ileal conduit. Analyses were performed an intention-to-treat basis. RESULTS: Of the…

Collecting electronic patient-reported outcomes via smartphone text messages in a bladder cancer RCT: A feasibility study.

Urologic oncology · 2026 · PMID 42235120

Patient-reported outcome measures are increasingly used to assess symptoms, treatment tolerance, and quality of life (QoL) in oncology. Electronic patient-reported outcome measures (ePROM) offer advantages over paper questionnaires, but large-scale evidence using smartphone text messaging in clinical trials is limited. To evaluate the feasibility of collecting ePROM via smartphone text messages in a large-scale, multinational randomized controlled trial of patients receiving Bacillus Calmette-Guérin therapy for non…

Results of the Prospective Randomized UroFollow Trial Comparing Marker-guided Versus Cystoscopy-based Surveillance in Patients with Low/Intermediate-risk Bladder Cancer.

European urology oncology · 2025 · PMID 40340174

BACKGROUND AND OBJECTIVE: A growing body of evidence suggests that the intensity of current follow-up in non-muscle-invasive bladder cancer (NMIBC) patients greatly exceeds clinical necessities. The UroFollow trial investigated the diagnostic accuracy of marker-based follow-up in patients with low/intermediate-risk NMIBC against the standard of care (SOC) for noninferiority (margin: <20%). METHODS: Patients with Ta low- and high-grade (G1-2) NMIBC were randomized to the SOC or 6-monthly marker-based follow-up (algo…

Association of energy source with outcomes in en bloc TURB: secondary analysis of a randomized trial.

World journal of urology · 2025 · PMID 40146341

PURPOSE: To comprehensively evaluate the efficacy of different energy sources used for en-bloc transurethral resection of bladder tumors (ERBT) on perioperative outcomes. METHODS: This sub-analysis derived from a prospective randomized study that enrolled patients undergoing ERBT vs conventional transurethral resection of the bladder (cTURB) from January 2019 to January 2022 (NCT03718754). Endpoints were pathological specimen quality and perioperative outcomes after either monopolar (m-ERBT) or bipolar (b-ERBT) or …

A 3-arm randomized control trial to compare the efficacy of re-circulant hyperthermic intravesical chemotherapy versus conventional intravesical mitomycin C and BCG therapy for intermediate-risk non-muscle invasive bladder cancer.

World journal of urology · 2024 · PMID 39480527

INTRODUCTION: To evaluate the efficacy and side effects of re-circulant hyperthermic intravesical chemotherapy versus conventional treatments for intermediate risk non-muscle invasive bladder cancer (NMIBC). METHODS: A randomized 3-arm, parallel group trial was conducted at a single tertiary care centre. 135 patients with low-grade intermediate-risk cancer, having undergone complete resection of bladder tumor were included. Patients were assigned 1:1:1, to receive intra-vesical chemo-hyperthermia (C-HT), mitomycin-…

A randomized prospective trial comparing Bacillus Calmette-Guérin (BCG) RIVM and Russian strains in non-muscle invasive bladder cancer: Efficacy and side effects.

Urologic oncology · 2025 · PMID 41006133

BACKGROUND: Intravesical Bacillus Calmette-Guérin (BCG) therapy is widely used as an adjuvant treatment for non-muscle-invasive bladder cancer (NMIBC). However, the optimal BCG substrain remains undetermined. This study compares the efficacy and safety of the BCG RIVM and Russian substrains in NMIBC treatment. OBJECTIVE: To evaluate recurrence-free survival (RFS), progression-free survival (PFS), and adverse event profiles between the 2 substrains. METHODS: In this randomized prospective trial, 149 patients with in…

Optimal adjuvant intravesical therapy for intermediate risk non-muscle invasive bladder cancer; oncological and patient-reported outcomes of randomized controlled trial.

Urologic oncology · 2026 · PMID 41689868

BACKGROUND: Adjuvant Intravesical BCG and chemotherapy are utilized viables options for intermediate-risk (IR) NMIBC. We are lacking well-designed evidence for superiority of any in terms of effectiveness, toxicity, and patient tolerability. OBJECTIVES: We compared the oncological outcomes, treatment-related adverse events (AEs) and Health-related quality of life (HRQoL) in IR NMIBC patients who received intravesical BCG vs. intravesical Epirubicin. MATERIALS AND METHODS: After institutional review board (IRB) appr…

Robot-assisted Radical Cystectomy with Totally Intracorporeal Urinary Diversion Versus Open Radical Cystectomy: 3-Year Outcomes from a Randomised Controlled Trial.

European urology · 2024 · PMID 38336579

BACKGROUND AND OBJECTIVE: Randomised controlled trials (RCTs) comparing open radical cystectomy (ORC) and robot-assisted RC (RARC) have involved an extracorporeal approach for urinary diversion (UD), undermining the potential benefits of a totally robotic procedure. Our objective was to compare 3-yr outcomes from a RCT comparing ORC to RARC with totally intracorporeal UD (iUD). METHODS: Patients with cT2-4 N0 M0 or bacillus Calmette-Guérin-failed high-grade non-muscle-invasive urothelial carcinoma who were candidat…

Final Results from SAUL, a Single-arm International Study of Atezolizumab in Unselected Patients with Pretreated Locally Advanced/Metastatic Urinary Tract Carcinoma.

European urology focus · 2024 · PMID 38839505

BACKGROUND AND OBJECTIVE: We assessed the safety of atezolizumab in unselected patients (including understudied populations typically excluded from clinical trials) with pretreated urinary tract carcinoma (UTC). The prespecified final analysis updates previously reported safety and efficacy data. METHODS: The single-arm prospective SAUL study (NCT02928406) enrolled 1004 patients with locally advanced/metastatic urothelial/non-urothelial UTC that had progressed during/after one to three prior treatment lines for adv…

Monopolar versus bipolar transurethral resection of bladder Tumour: post-hoc analysis of a prospective trial.

World journal of urology · 2024 · PMID 39093420

INTRODUCTION: Previously, in a randomised trial we demonstrated bipolar transurethral resection of bladder tumor (TURBT) could achieve a higher detrusor sampling rate than monopolar TURBT. We hereby report the long-term oncological outcomes following study intervention. METHODS: This is a post-hoc analysis of a randomized phase III trial comparing monopolar and bipolar TURBT. Only patients with pathology of non-muscle invasive bladder cancer (NMIBC) were included in the analysis. Per-patient analysis was performed.…

Impact of a Perioperative Smoking and Alcohol Cessation Intervention on Health-related Quality of Life in Patients Undergoing Radical Cystectomy: A Randomised Controlled Trial.

European urology focus · 2025 · PMID 40744855

BACKGROUND AND OBJECTIVE: The impact of a smoking and alcohol cessation intervention on health-related quality of life (HRQoL) following radical cystectomy (RC) is unclear. This study aimed to evaluate the effect of a 6-wk perioperative smoking and/or alcohol cessation intervention on HRQoL. A secondary objective was to assess the difference in HRQoL between patients with more than two and those with fewer complications. METHODS: From 2014 to 2018, 104 patients referred to RC who smoked daily or consumed at least t…