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 …

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…

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…

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.

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…

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…

Comparison of long-term survival for muscle-invasive bladder cancer patients who underwent bladder preservation therapy and radical cystectomy: A systematic review and meta-analysis.

Urologia · 2025 · PMID 40572045

OBJECTIVE/PURPOSE: This study aims to compare BPT and RC for long-term survival and quality of life outcomes in MIBC patients. MATERIALS AND METHODS: The study conducted based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020, with search strategy across databases (PubMed, Scopus, Cochrane Library, EMBASE, and MEDLINE) used relevant keywords. RCTs, observational studies, and simulation studies were included. Each included study was evaluated with the Newcastle-Ottawa Scale (NOS) fo…

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…

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…

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…

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…

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…

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)…

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…

Updates in bladder and prostate pathology: Diagnostic consensus and clinical relevance.

Human pathology · 2026 · PMID 41412445

Accurate grading, staging, and classification are essential components of bladder and prostate cancer pathology, directly influencing clinical management and patient outcomes. Recent initiatives by the International Society of Urological Pathology (ISUP) and the Genitourinary Pathology Society (GUPS) have produced key consensus updates aimed at refining diagnostic criteria and resolving long-standing controversies. This review highlights high-impact developments in bladder and prostate pathology, including updated …

The Dublin International Society of Urological Pathology (ISUP) Consensus Conference on Best Practice Recommendations on the Pathology of Glandular Lesions of the Urinary Bladder.

Advances in anatomic pathology · 2026 · PMID 40757456

The Dublin ISUP Consensus Conference covered the proceedings on the best practice recommendations on nonurachal glandular lesions of the urinary bladder, bladder diverticular cancers, and molecular features of bladder and urachal glandular lesions. The conference proceedings on urachal neoplasms (except for their molecular features) are published elsewhere. The rationale for convening this conference was the lack of structured and consented pathologic recommendations in these rare lesions. Consensus by participants…

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…

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…

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 …

Clinicopathological Predictors of Survival After Radical Nephroureterectomy for UTUC: A Propensity Score-Matched Multicenter Analysis.

Clinical genitourinary cancer · 2026 · PMID 42315458

INTRODUCTION: Upper tract urothelial carcinoma (UTUC) is characterized by heterogeneous outcomes and high recurrence risk. We aimed to identify independent predictors of survival and intravesical recurrence using a bias-adjusted statistical framework. PATIENTS AND METHODS: We retrospectively analyzed 503 patients undergoing radical nephroureterectomy (RNU). Beyond Multivariable Cox regression, propensity score matching (PSM) was used to evaluate the impact of adjuvant chemotherapy. Perioperative estimated glomerula…

Marked attenuation of P63 expression in plasmacytoid urothelial carcinoma with expanded immunohistochemical framework including E-cadherin, P120, HER2 and TRPS1.

Histopathology · 2026 · PMID 42086287

AIMS: Plasmacytoid urothelial carcinoma (PUC) is an aggressive morphological subtype characterized by discohesive single-cell infiltration and frequent loss of epithelial adhesion. Although p63 is widely regarded as a reliable urothelial lineage marker in conventional urothelial carcinoma, its expression may be reduced or absent in plasmacytoid tumours, creating an important diagnostic pitfall. This multi-institutional study aimed to characterize the clinicopathological and immunohistochemical profile of PUC, with …

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…

PD-L1 expression across urothelial carcinoma subtypes: A multicenter comparison of 22C3 and SP142 for clinical decision-making in the immunotherapy era.

Pathology, research and practice · 2026 · PMID 41764808

BACKGROUND: Urothelial carcinoma with histological subtypes (UC-s) presents diverse biological behaviours and therapeutic responses. PD-L1 immunoexpression has become a key biomarker for guiding immune checkpoint inhibitor therapy in advanced UC. However, the role of PD-L1 across UC-s remains limited characterized, with discrepancies reported between assays. OBJECTIVE: This multicenter retrospective study aimed to assess PD-L1 expression patterns in 169 UC-s cases using two assays (22C3 and SP142), with analysis of…

Immunohistochemical Expression of p63 and GATA3 in Lymphomas of the Urinary Bladder: A Clinicopathologic Study of a Potential Diagnostic Pitfall.

International journal of surgical pathology · 2026 · PMID 41985039

Urinary bladder lymphomas are rare and may mimic urothelial carcinoma by morphology or unexpected expression of putative "urothelial" markers such as p63/ GATA3, the latter of which has not been thoroughly explored. Herein, we evaluate the clinicopathologic features of bladder lymphomas and assess the incidence of p63/GATA3 expression. A multi-institutional review identified 28 bladder lymphomas. Slides were re-reviewed for lymphoma subtype, growth pattern, urothelial colonization, and concurrent urothelial carcino…

Medical cannabis treatment non-adherence among oncology patients: A prospective cohort analysis in Israel.

European journal of oncology nursing : the official journal of European Oncology Nursing Society · 2026 · PMID 42302583

PURPOSE: Oncology patients frequently experience distressing symptoms. Medical cannabis (MC) is increasingly used, yet real-world MC discontinuation remains insufficiently characterized. This study aimed to identify baseline factors associated with voluntary MC non-adherence over six months among oncology patients. METHOD: Voluntary MC non-adherence was defined as patient-initiated discontinuation due to perceived ineffectiveness and/or MC-related adverse effects (AEs) at any follow-up point. Patients who continued…

Pan-cancer analysis identifies immunoproteasome as the predominant survival-associated component of antigen processing machinery.

Translational oncology · 2026 · PMID 42364494

Neoantigens are critical targets for cancer immunotherapy, yet the relationship between experimentally validated neoantigen burden and antigen processing machinery (APM) expression in determining clinical outcomes remains unclear. We mapped CEDAR-annotated neoantigens (CENs) onto mutation data from 43,980 patients across 14 cancer types using cBioPortal. APM gene expression was correlated with survival outcomes across 13 cohorts. Machine learning approaches (elastic net stability selection, random survival forest, …

Integration of Node-RADS and Habitat Radiomics for Predicting Occult Nodal Metastasis in Bladder Cancer.

Annals of surgical oncology · 2026 · PMID 41968233

BACKGROUND: This study aimed to evaluate the role of tumor habitat analysis in predicting occult nodal metastasis (ONM) in bladder cancer patients. METHODS: This retrospective study enrolled 84 bladder cancer patients who underwent pelvic lymphadenectomy. The tumor area was segmented into sub-regions using a Fuzzy C-Means clustering algorithm based on Hounsfield unit (HU) values. Independent clinical factors related to ONM were screened through univariate logistic regression analysis. Radiomics features were extrac…

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 …

Aspirin or non-steroidal anti-inflammatory drug initiation and subsequent bladder cancer evaluation.

Journal of internal medicine · 2026 · PMID 42220091

BACKGROUND: Whether aspirin or non-aspirin non-steroidal anti-inflammatory drugs (NSAIDs) initiation may unmask unknown bladder cancers (BCs) by hematuria remains controversial. OBJECTIVES: To evaluate unmasking, we compared cystoscopy rates, BC prevalence at cystoscopy, and invasive stage prevalence at diagnosis in aspirin or NSAID initiators with never-users. METHODS: Using the Danish population-based registries, we identified all new aspirin or NSAID users in 2005-2023 and a matched never-using comparison cohort…

Keratin 17 immunocytochemistry in urine cytology for urothelial carcinoma detection: Diagnostic performance and interobserver agreement in a prospective real-world cohort.

Cancer cytopathology · 2026 · PMID 42421607

BACKGROUND: Urine cytology is recommended for noninvasive detection of urothelial carcinoma (UC) but shows limited sensitivity, particularly in low-grade disease. Keratin 17 (K17) has emerged as a promising immunocytochemical marker. This study evaluated the diagnostic performance and interobserver agreement of K17 in a routine setting. METHODS: This prospective cross-sectional study included 184 urine samples from patients undergoing diagnostic evaluation for suspected UC. K17 immunocytochemistry was performed wit…

Machine-learning-assisted artificial olfactory colorimetric sensor array for bladder cancer early detection from urinary volatile organic compounds.

Biosensors & bioelectronics · 2026 · PMID 42302328

Bladder cancer (BC) remains difficult to detect non-invasively because current diagnostic methods are either invasive or insufficiently sensitive for early-stage disease. In this study, we developed a machine-learning-assisted artificial olfactory colorimetric sensor array (CSA) for urinary volatile organic compound (VOC)-based BC screening. The CSA was fabricated by integrating eight cross-reactive dyes into electrospun poly(vinylidene fluoride) (PVDF) nanofibrous membranes. The porous and hydrophobic PVDF matrix …

Prediction of immune-related adverse events in urological cancer during checkpoint inhibitor immunotherapy through immunohistochemical analysis of tumorous LCP1/ADPGK.

Translational oncology · 2026 · PMID 42241990

Immune checkpoint inhibitors (ICIs) have revolutionized the treatment of urological cancers. But immune-related adverse events (irAEs), especially high-grade irAEs, are a significant risk factor for survival and prognosis in this group of patients. As such, the ability to predict irAEs is of great interest. We retrospectively examined baseline blood tests, biochemical markers, and tumor expression of LCP1 and ADPGK in 112 patients with urological cancers who received either PD-1 or PD-L1 antibodies. LCP1 positivity…

Application of computed diffusion-weighted imaging in vesical imaging reporting and data system assessment for bladder cancer.

Abdominal radiology (New York) · 2026 · PMID 41454947

PURPOSE: To validate computed diffusion-weighted imaging (cDWI) as a time-efficient alternative to acquired DWI (aDWI) in Vesical Imaging-Reporting and Data System (VI-RADS) assessment for bladder cancer, addressing inherent limitations of low signal-to-noise ratio (SNR) and motion artifacts in conventional high-b-value DWI. METHODS: This retrospective diagnostic accuracy study evaluated 110 patients (mean age 67.8 ± 9.59 years, 100 men) with pathologically confirmed urothelial carcinoma. All underwent 3.0T MRI inc…

Computed tomography-derived extracellular volume fraction is associated with high-grade recurrence in non-muscle-invasive bladder cancer treated with intravesical gemcitabine and docetaxel.

BJU international · 2026 · PMID 42206900

OBJECTIVES: To evaluate whether extracellular volume (ECV) fraction derived from contrast-enhanced computed tomography (CT) is associated with recurrence risk in patients with treatment-naïve high-risk non-muscle-invasive bladder cancer (HR-NMIBC) receiving intravesical gemcitabine/docetaxel (Gem/Doce) therapy. PATIENTS AND METHODS: This retrospective cohort study, conducted at a tertiary referral centre, included 103 patients with HR-NMIBC treated with intravesical Gem/Doce between 2012 and 2024. All patients unde…

Decision tree models combining Bi-parametric vesical imaging reporting and data system and apparent diffusion coefficient metrics for predicting muscle-invasive bladder cancer.

Abdominal radiology (New York) · 2026 · PMID 41575494

PURPOSE: To compare whole-lesion apparent diffusion coefficient (ADC) histogram analysis with representative ADC value for assessing muscle invasion in bladder cancer, and to build a decision tree model that combines bi-parametric Vesical Imaging Reporting and Data System (bp VI-RADS) with ADC values. METHODS: This retrospective study included 82 patients with bladder cancer who underwent 3T MRI and transurethral resection. The bp VI-RADS was scored using T2-weighted and diffusion-weighted imaging, and ADC maps. Fo…

SEPT9 methylation as a potential biomarker for uncovering latent malignancy in flat urothelial lesions.

Annals of diagnostic pathology · 2026 · PMID 42105694

Accurate differentiation between reactive and neoplastic flat urothelial lesions is critical for patient management; however, cystoscopic biopsy often results in false negatives because of sampling limitations and interpretive challenges. This study evaluated the diagnostic utility of SEPT9 methylation as a molecular biomarker in 134 cystoscopic biopsy lesions, categorized as reactive urothelial atypia (RUA, n = 58), dysplasia (DYS, n = 25), carcinoma in situ (CIS, n = 12) and indeterminate lesions (n = 39). SEPT9 …

Performance of Urine Tumor DNA Detection in Patients with High-grade Non-muscle-invasive Bladder Cancer Undergoing Repeat Transurethral Resection.

European urology focus · 2026 · PMID 42538173

BACKGROUND AND OBJECTIVE: Patients with high-risk non-muscle invasive bladder cancer (NMIBC) experience high recurrence rates and potential understaging, supporting guideline recommendations for repeat transurethral resection (reTUR). However, identifying patients best suited for reTUR remains challenging. Here, we analyze urine tumor DNA (utDNA) for mutations associated with urothelial cancer in a cohort of patients undergoing reTUR. METHODS: Retrospective evaluation of urine samples from 43 patients with patholog…

Cascaded confinement-encapsulated fluorescence nano-immunomachine for noninvasive urinary monitoring of bladder cancer.

Biosensors & bioelectronics · 2026 · PMID 42537420

Urinary protein biomarker analysis holds immense promise for noninvasive tumor monitoring; however, current assays are limited by multi-step operations and matrix interference. Herein, we developed a one-pot fluorescence nano-immunomachine for ultrasensitive quantification of urinary bladder cancer-specific nuclear matrix protein 4 (BLCA-4), driven by cascaded confinement-mediated quantum dots encapsulation in DNA nanospheres. Programmed DNA self-assembly and phenyllactic acid-mediated framework condensation jointl…

Future Directions: Artificial Intelligence and Digital Tools in Bladder Cancer Care.

The Urologic clinics of North America · 2026 · PMID 42362307

This comprehensive review examines using artificial intelligence (AI) across the diagnostic, therapeutic, and prognostic landscape of bladder cancer. It highlights AI's capacity to enhance tumor detection, histopathologic interpretation, surgical precision, and personalized treatment planning through machine learning and computer vision. Applications such as AI-assisted cystoscopy, cytology, transurethral resection of bladder tumor optimization, and prognostic modeling demonstrate significant potential to reduce va…

Glycovariant-based diagnosis of bladder cancer using urinary mucin 1 and carcinoembryonic antigen.

Journal of pharmaceutical and biomedical analysis · 2026 · PMID 42250336

Glycan alterations, or glycovariants (GV), are well-recognized features of malignant transformation and are commonly observed in several cancers, including bladder cancer (BlCa). However, their integration into practical diagnostic assays remains limited. Here, we investigated whether glycan modifications on the urinary glycoproteins mucin 1 (MUC1) and carcinoembryonic antigen (CEA) could serve as diagnostic indicators for BlCa diagnosis. MUC1 and CEA were captured directly from urine samples of patients with benig…

Universally offered germline testing in upper tract urothelial carcinoma.

Urologic oncology · 2026 · PMID 42542401

PURPOSE: Upper tract urothelial carcinoma (UTUC) is a common extracolonic manifestation of Lynch syndrome (LS) characterized by mismatch repair deficiency (MMR-D) and microsatellite instability (MSI). LS detection in UTUC relies on tissue- and clinical-based screening, which can fail to detect pathogenic germline variants (PGVs). We sought to determine the prevalence and spectrum of PGVs in UTUC through universally offered germline testing. METHODS: In this retrospective, single-institution cohort, between 2020 and…

Targeting HER2 in Urothelial Carcinoma: Why Histologic Subtypes and Divergent Histologies Matter.

Clinical genitourinary cancer · 2026 · PMID 42259166

HER2 is emerging as a clinically relevant target in urothelial carcinoma (UC), but its biological and therapeutic significance is not uniform across histologic subtypes and divergent histologies. These tumors are characterized by marked clinicopathologic heterogeneity, aggressive behavior, and limited representation in prospective trials, complicating biomarker development. Available data suggest that ERBB2 alterations are enriched in selected subtypes, most consistently in micropapillary UC, whereas plasmacytoid, …

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…

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 …

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…

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 …

Current Evidence on the Use of Cystoscopy in the Follow-up of Non-Muscle-Invasive Bladder Cancer: Are We Overusing It? Systematic Review of the Literature.

Archivos espanoles de urologia · 2026 · PMID 42104689

BACKGROUND: Non-muscle-invasive bladder cancer (NMIBC) accounts for the majority of bladder cancers. Its follow-up entails high costs and significant impact on quality of life. Cystoscopy is the standard method, although uncertainties remain regarding the optimal frequency and duration. The aim was to review the available evidence on surveillance schedules and their impact on recurrence and progression. METHODS: A systematic review was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and…

Diagnostic Performance of Urinary Biomarker Tests in Detecting Bladder Cancer: A Systematic Review, Meta-analysis, and Network Meta-analysis.

Urology · 2026 · PMID 41651230

OBJECTIVE: To assess the diagnostic estimates of current urine-based diagnostic bladder tests for diagnosing bladder cancer using diagnostic test accuracy (DTA) and network meta-analysis (NMA). METHODS: The search for this systematic review and meta-analysis was conducted on PubMed and Medline for relevant studies published until September 30, 2025. The meta-analysis and network meta-analysis were performed using a random-effect model, to compute the pooled sensitivity and specificity of the markers. The qualitativ…

Impact of pelvic lymph node dissection on oncological outcomes in patients with clinically staged non-muscle-invasive bladder cancer undergoing radical cystectomy: A systematic review.

Critical reviews in oncology/hematology · 2026 · PMID 41655753

INTRODUCTION: In the majority of very high-risk and selected high-risk cases of clinically non-muscle-invasive bladder cancer (NMIBC), radical cystectomy (RC) may be performed. However, the necessity of pelvic lymph node dissection (PLND) in this clinical scenario is debated. The aim of this review was to evaluate how the presence and extent of PLND influence survival outcomes. MATERIALS AND METHODS: A systematic literature search was performed on July 6th, 2025, without language or time restrictions. Studies were …

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…

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 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…

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…

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…

Oncological Safety of Bladder Preservation in Elderly Patients with Muscle-Invasive Bladder Cancer.

Annals of surgical oncology · 2026 · PMID 41649780

BACKGROUND: The oncological safety of bladder preservation therapy (BPT) versus standard radical cystectomy (RC) in elderly patients with muscle-invasive bladder cancer (MIBC) remains controversial. MATERIALS AND METHODS: Adhering to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 statement and Assessing the Methodological Quality of Systematic Reviews (AMSTAR) guidelines, we conducted a systematic literature review of publications indexed in the PubMed, Embase, Web of Science, …

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…

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…

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…

Estimating the prevalence of germline mutations in DNA mismatch repair genes among patients with upper tract urothelial carcinoma: a systematic review and meta-analysis.

Urologic oncology · 2026 · PMID 41671923

BACKGROUND: Lynch syndrome is a hereditary cancer predisposition syndrome caused by germline mutations in the DNA mismatch repair (MMR) genes MSH2, MSH6, MLH1 and PMS2. The objective of this systematic review was to estimate the prevalence of germline mutations in MMR genes among patients with upper tract urothelial carcinoma (UTUC). METHODS: Literature searches were performed using MEDLINE, EMBASE and Web of Science Core Collection. Studies of interest were selected and data were abstracted independently by two re…

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…

Direct head-to-head comparison between neoadjuvant and adjuvant chemotherapy in upper tract urothelial carcinoma: A systematic review and meta-analysis.

Urologia · 2026 · PMID 41311058

The optimal timing of perioperative chemotherapy in upper tract urothelial carcinoma (UTUC) remains debated. We conducted a meta-analysis to compare neoadjuvant chemotherapy (NAC) versus adjuvant chemotherapy (AC) in terms of pathological and survival outcomes. A systematic search identified eligible studies directly comparing NAC and AC in UTUC patients. Five studies with 1938 patients were included. Compared with AC, NAC achieved higher rates of pathological downstaging (OR: 2.13; 95% CI: 1.21-3.76) and a lower r…

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…

Exposures and Bladder Cancer Risk Among Military Veterans: A Systematic Review and Meta-analysis.

Urology · 2024 · PMID 39153606

OBJECTIVE: To investigate potential carcinogenic exposures in military personnel that are implicated in the development of bladder cancer. METHODS: This systematic review aimed to evaluate the association between specific military exposures and bladder cancer risk among veterans. PubMed, Scopus, and Ovid MEDLINE databases were searched in December 2023 for relevant articles. Inclusion criteria comprised retrospective cohort studies, reviews, and observational studies documenting bladder cancer incidence among milit…

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…

Active surveillance for non-muscle invasive bladder cancer: A systematic review and pooled-analysis.

Cancer treatment and research communications · 2021 · PMID 33838570

INTRODUCTION: One of the Non-Muscle Invasive Bladder Cancer (NMIBC) treatment options recently recommended by International Guidelines is represented by Active Surveillance (AS),. Herein we carried out a systematic review and pooled-analysis of currently available evidences in order to provide recommendations for daily urological practice. MATERIAL AND METHODS: The PubMed, EMBASE, and Coch rane Library databases were searched with the terms "Non-Muscle Invasive" or "pTa/pT1" and "Bladder Cancer" or "Bladder Tumor".…

Significance of PD-L1 in Metastatic Urothelial Carcinoma Treated With Immune Checkpoint Inhibitors: A Systematic Review and Meta-Analysis.

JAMA network open · 2024 · PMID 38446479

IMPORTANCE: Immune checkpoint inhibitors (ICIs) have broadened the metastatic urothelial carcinoma (mUC) therapeutic scenario. The association of programmed death ligand 1 (PD-L1) with response and survival in patients treated with ICIs is still controversial. OBJECTIVES: To evaluate the association of PD-L1 with response rate and overall survival among patients with mUC treated with ICIs. DATA SOURCES: PubMed, Embase, American Society of Clinical Oncology and European Society for Medical Oncology Meeting Libraries…

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…

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…

Metastasis-directed Therapy in the Management of Urothelial Carcinoma: A Systematic Review and Meta-analysis.

European urology focus · 2025 · PMID 40175243

BACKGROUND AND OBJECTIVE: In this prospectively registered meta-analysis (PROSPERO: CRD42024501283), we pooled data on patients treated with metastasis-directed therapies (MDTs) for metastatic urothelial cancer (mUC). METHODS: On January 24, 2024, we searched PubMed (MEDLINE), Scopus, and Google Scholar for studies on consolidative MDT in patients with mUC. The search was updated on August 25, 2024. Reports of MDT for brain metastases were excluded. The survival data were synthesised with a distribution-free approa…

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…

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

Xpert bladder cancer monitor in surveillance of bladder cancer: Systematic review and meta-analysis.

Urologic oncology · 2022 · PMID 34535354

INTRODUCTION: There is a need for sensitive and specific biomarkers for detecting recurrences in patients with non-muscle invasive bladder cancer (NMIBC) on surveillance. Xpert bladder cancer (BC) monitor is the latest rapid in vitro qualitative test that detects expression of 5 mRNAs using a GeneXpert instrument. The primary aim of this review was to systematically review and pool the data regarding the diagnostic performance of Xpert BC in patients with NMIBC. METHODS: Systematic literature search using 4 electro…

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…

Immuno-oncology therapy in metastatic bladder cancer: A systematic review and network meta-analysis.

Critical reviews in oncology/hematology · 2022 · PMID 34823022

CONTEXT: Three first line and three second-line clinical trials tested the effect of immunotherapy (IO) relative to standard chemotherapy (CT) on overall survival. However, network meta-analysis-based comparisons have not yet been presented. We addressed this void. OBJECTIVE: To provide comparisons of overall survival (OS), progression-free survival (PFS), complete response (CR), partial response (PR), stable disease (SD), objective response rates (ORR), disease control rates (DCR) and adverse events (AEs) associat…

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…

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…

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…

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…

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…

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…

Prognostic Value of Tumor Budding in Urothelial Carcinoma: A Meta-Analysis and Systematic Review.

Laboratory investigation; a journal of technical methods and pathology · 2023 · PMID 36990153

Recently, tumor budding (TB) has been suggested as a strong prognostic marker in urinary tract urothelial carcinoma (UC). The aim of this systematic review is to test the prognostic value of TB in UC by a meta-analysis of previously published studies. We systematically reviewed the literature related to TB by using the databases of Scopus, PubMed, and Web of Science. The search was limited to publications in the English language up to July 2022. There were 790 patients from 7 retrospective studies in which TB has b…

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…

Quality of life in bladder cancer: systematic review and meta-analysis.

BMJ supportive & palliative care · 2024 · PMID 37400163

BACKGROUND: Worldwide, bladder cancer (BC) has been regarded as the tenth most common cancer with more than 573 000 new cases in 2020. This research presents a systematic review and meta-analysis of studies examining the quality of life (QOL) among patients with BC. METHODS: The study was designed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A total of 11 articles were extracted from a literature search conducted through electronic databases including PubMed, EMBASE, S…

Bladder cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up.

Annals of oncology : official journal of the European Society for Medical Oncology · 2022 · PMID 34861372

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…

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-…

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…

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 …

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…

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…

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…

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…

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…

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…

Evaluating BCG response in primary and metachronous non-muscle invasive bladder cancer following prior upper tract urothelial cancer: A systematic review and meta-analysis.

Urologic oncology · 2026 · PMID 41956941

INTRODUCTION: Emerging evidence suggests that metachronous non-muscle invasive bladder cancer (m-NMIBC) recurrence after prior upper tract urothelial carcinoma (UTUC) treatment is distinct from primary NMIBC (p-NMIBC). Correspondingly, their disease trajectories and treatment responses may differ vastly. This systematic review aims to evaluate the differences in Bacillus Calmette-Guérin (BCG) response between m-NMIBC and p-NMIBC. METHODS: A comprehensive literature search (PubMed, Embase, and Scopus) was performed …

Distal ureterectomy versus radical nephroureterectomy for nonmetastatic distal ureteral urothelial carcinoma: a GRADE-assessed systematic review and meta-analysis of comparative studies.

World journal of surgical oncology · 2026 · PMID 42216175

BACKGROUND: The oncologic adequacy of distal ureterectomy (DU) versus radical nephroureterectomy (RNU) for nonmetastatic distal ureteral urothelial carcinoma remains debated, particularly in patients for whom renal preservation is clinically desirable. METHODS: A systematic review and meta-analysis of comparative studies was performed. PubMed/MEDLINE, Embase, Scopus, Web of Science, and the Cochrane Library were searched from inception to February 27, 2026. A total of 229 records were identified, 14 full-text artic…

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…

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…

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…

The evolving landscape and clinical utility of circulating tumor DNA across the spectrum of urothelial carcinoma: A systematic review and framework for clinical integration.

Cancer · 2026 · PMID 42262988

Urothelial carcinoma (UC) is a significant global health challenge with heterogeneous clinical presentations from nonmuscle-invasive to metastatic disease. Circulating tumor DNA (ctDNA) has emerged as promising noninvasive biomarker for risk classification, treatment monitoring and recurrence detection. Systematic searches of PubMed identified 390 articles; 61 met inclusion criteria for plasma ctDNA analysis in UC. Independent dual screening, Joanna Briggs Institute assessment, and stratification by disease stage (…

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…

Risk factors for intraoperative hypotension associated with the use of oral 5-aminolevulinic acid as a photodynamic diagnostic agent in transurethral resection of bladder tumors: A meta-analysis.

Photodiagnosis and photodynamic therapy · 2026 · PMID 41724311

AIM: The photodynamic diagnostic agent oral 5-aminolevulinic acid (5-ALA) promotes the selective accumulation of protoporphyrin IX in tumor cells and is used for intraoperative visualization of tumor tissue in the diagnosis and treatment of non-invasive bladder cancer confined to the muscle. However, the use of oral 5-ALA in photodynamic diagnosis has been reported to cause intraoperative hypotension during urologic surgery. Therefore, this meta-analysis was conducted to identify risk factors for intraoperative hyp…

Blood and Urine Circulating Tumor DNA in Urothelial Bladder Cancer: State of the Art and Clinical Perspective.

European urology oncology · 2026 · PMID 41862336

BACKGROUND AND OBJECTIVE: Urothelial bladder cancer (UBC) carries significant mortality and treatment morbidity. Conventional diagnostic and monitoring methods, including cystoscopy and biopsy, are invasive and limited in sensitivity. Circulating tumor DNA (ctDNA), a minimally-invasive "liquid biopsy," has emerged as a promising tool for real-time disease assessment. This study aimed to systematically evaluate the diagnostic, prognostic, and predictive value of plasma and urine ctDNA in localized, locally advanced,…

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 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…

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 …

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…

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…

Intravesical cretostimogene grenadenorepvec oncolytic immunotherapy in high-risk, BCG-unresponsive, non-muscle-invasive bladder cancer with carcinoma in situ (BOND-003 Cohort C): a single-arm, phase 3 trial.

The Lancet. Oncology · 2026 · PMID 42508433

BACKGROUND: There are few bladder-sparing treatment options for high-risk, BCG-unresponsive, non-muscle-invasive bladder cancer that are effective and have a manageable adverse event profile. Cretostimogene grenadenorepvec (hereafter, cretostimogene) is an oncolytic immunotherapy with dual mechanisms of action-it replicates in and lyses cancer cells with retinoblastoma-E2F pathway alterations and amplifies the immune response. We evaluated the response and safety/tolerability of cretostimogene in patients with high…

En-bloc Resection of Bladder Tumor Versus Conventional Transurethral Resection of Bladder Tumor: Long-term Oncological Outcomes from a Single-center Prospective Trial.

European urology focus · 2026 · PMID 42542426

Prior randomized trials have shown that en bloc transurethral resection of bladder tumor (ERBT) is noninferior to conventional transurethral resection of bladder tumor (cTURBT) for pathological staging. To address gaps in long-term oncologic outcomes, we conducted a post hoc analysis of a single-center randomized trial including 219 of the 248 patients treated between 2018 and 2021, evaluating overall survival (OS), cancer-specific survival (CSS), and cumulative incidence of urothelial recurrence with a median foll…

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,…

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…

Clinical Impact of Immune Checkpoint Inhibitors and Chemotherapy in the First-Line Treatment of Metastatic Urothelial Carcinoma with Variant Histology.

Urologia internationalis · 2026 · PMID 42263038

INTRODUCTION: Treatment of metastatic urothelial carcinoma (mUC) has evolved. The efficacy of chemotherapy (CT) and immune checkpoint inhibitors (ICIs) against UC with variant differentiation (UC-VD) or pure variant histology (PVH) is rarely reported. This study assessed the clinical impact of first-line (1L) CT and/or ICI in patients with UC-VD or PVH. METHODS: This retrospective study included patients treated with 1L palliative CT or ICI at the West German Tumor Center Essen (2006-2024). Treatment allocation ref…

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…

PIK3CB Inhibitor GSK2636771 in Cancers With PTEN Mutation/Deletion or Loss of PTEN Protein Expression: Results From the NCI-MATCH ECOG-ACRIN Trial (EAY131) Subprotocols N and P.

JCO precision oncology · 2025 · PMID 40865033

PURPOSE: PTEN loss contributes to aberrant signaling of the phosphatidylinositol 3-kinase (PI3K)/protein kinase B/mammalian target of rapamycin pathway and may confer sensitivity to therapies targeting the PI3K pathway. The PIK3CB inhibitor GSK2636771 demonstrated efficacy in tumors with PIK3CB mutations and may similarly show efficacy in patients with PTEN loss. METHODS: Two nonrandomized, open-label phase II subprotocols within the context of the NCI-MATCH trial targeted PTEN tumor alterations in patients with ad…

Prospective multicenter study of ctDNA versus tumor tissue guiding FGFR-targeted therapy in metastatic urothelial cancer.

Nature communications · 2026 · PMID 41760649

Fibroblast growth factor receptor (FGFR) alterations are targetable in metastatic urothelial carcinoma (mUC). Identifying FGFR alterations currently requires tissue testing, which is limited by sample availability and cancer heterogeneity. Plasma circulating tumor DNA (ctDNA) offers a complementary testing strategy, but the added value of ctDNA relative to conventional FGFR alteration assessment remains unclear. Here, in a prospective, multicentre study, we show that ctDNA testing has high concordance with tissue F…

Concomitant medications and survival outcomes in patients receiving avelumab maintenance for advanced urothelial carcinoma: sub analysis of Meet-URO 25 study.

Clinical genitourinary cancer · 2026 · PMID 42067484

BACKGROUND: Concomitant medications may impair immune checkpoint inhibitor (ICI) activity through modulation of the gut microbiome and systemic immunity. While a medication-based risk model (drug score) has been validated in pan-cancer cohorts, evidence in advanced urothelial carcinoma (aUC) remains limited. This study assessed the association between concomitant medications and survival in patients receiving avelumab maintenance in the Meet-URO 25 cohort. METHODS: We retrospectively analyzed patients with aUC trea…

PD-L1 expression across urothelial carcinoma subtypes: A multicenter comparison of 22C3 and SP142 for clinical decision-making in the immunotherapy era.

Pathology, research and practice · 2026 · PMID 41764808

BACKGROUND: Urothelial carcinoma with histological subtypes (UC-s) presents diverse biological behaviours and therapeutic responses. PD-L1 immunoexpression has become a key biomarker for guiding immune checkpoint inhibitor therapy in advanced UC. However, the role of PD-L1 across UC-s remains limited characterized, with discrepancies reported between assays. OBJECTIVE: This multicenter retrospective study aimed to assess PD-L1 expression patterns in 169 UC-s cases using two assays (22C3 and SP142), with analysis of…

Immunohistochemical Expression of p63 and GATA3 in Lymphomas of the Urinary Bladder: A Clinicopathologic Study of a Potential Diagnostic Pitfall.

International journal of surgical pathology · 2026 · PMID 41985039

Urinary bladder lymphomas are rare and may mimic urothelial carcinoma by morphology or unexpected expression of putative "urothelial" markers such as p63/ GATA3, the latter of which has not been thoroughly explored. Herein, we evaluate the clinicopathologic features of bladder lymphomas and assess the incidence of p63/GATA3 expression. A multi-institutional review identified 28 bladder lymphomas. Slides were re-reviewed for lymphoma subtype, growth pattern, urothelial colonization, and concurrent urothelial carcino…

A small-molecule inverse agonist of PPARγ for advanced solid tumors: a phase 1 trial.

Nature medicine · 2026 · PMID 41760953

Peroxisome proliferator-activated receptor gamma (PPARγ) is a master regulator of luminal lineage in urothelial carcinoma. FX-909 is a first-in-class oral small-molecule PPARγ inverse agonist. Here we report the first part of FX-909-CLINPRO-1, a phase 1A 3 + 3 dose-escalation study of FX-909, that enrolled 56 patients with advanced solid tumors, including 46 with urothelial carcinoma. The primary end point was safety and tolerability; secondary end points included recommended phase 2 dose determination, pharmacokin…

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…

Pan-cancer analysis identifies immunoproteasome as the predominant survival-associated component of antigen processing machinery.

Translational oncology · 2026 · PMID 42364494

Neoantigens are critical targets for cancer immunotherapy, yet the relationship between experimentally validated neoantigen burden and antigen processing machinery (APM) expression in determining clinical outcomes remains unclear. We mapped CEDAR-annotated neoantigens (CENs) onto mutation data from 43,980 patients across 14 cancer types using cBioPortal. APM gene expression was correlated with survival outcomes across 13 cohorts. Machine learning approaches (elastic net stability selection, random survival forest, …

Perioperative therapy in muscle-invasive bladder cancer: real-world evidence from the MINOTAURO study.

ESMO real world data and digital oncology · 2026 · PMID 42518717

BACKGROUND: Radical cystectomy with neoadjuvant and/or adjuvant therapy is the standard treatment of muscle-invasive urothelial cancer (MIUC). Although perioperative immunotherapy use has expanded, real-world data remain limited. The MINOTAURO study evaluated perioperative treatment patterns and outcomes in Spain. PATIENTS AND METHODS: This retrospective, multicenter study included adults with MIUC treated at 17 hospitals in Northern and Eastern Spain (April 2022-June 2024). Clinical data were extracted from electr…

Genitourinary malignancy among patients presenting with microscopic hematuria in Northwestern Ontario.

Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2026 · PMID 41941258

INTRODUCTION: Microscopic hematuria (MH) may indicate an underlying genitourinary (GU) malignancy. Accordingly, MH workup is essential to mitigate GU cancer-related morbidity and mortality. This study aimed to evaluate the etiologies of MH in Northwestern Ontario, Canada. METHODS: We conducted a retrospective cohort chart review of 2545 patients referred to our institution for MH from 2010-2020. Demographic and clinical data were collected. Low- and high-grade MH were defined as ≤25 and >25 red blood cells (RBCs) p…

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 …

Venous thromboembolism in urothelial bladder cancer - scope of the problem and patients' perspectives: VTE-UBC.

Wiadomosci lekarskie (Warsaw, Poland : 1960) · 2026 · PMID 42536929

OBJECTIVE: Aim: This study investigates the scope of VTE in people with UBC in the UK and explores their understanding of VTE from their experience of having cancer and anti-cancer treatments, alongside the perspectives of healthcare professionals (HCPs). PATIENTS AND METHODS: Materials and Methods: A sequential mixed-methods study was applied: Phase I - quantitative, exploring the incidence and risk factors for VTE in UBC, by cohort of UK Hospital Episodes Statistics (HES) data and a retrospective case-control ana…

Differential effects of prior versus concomitant Steroid and Antibiotic Treatment on Immunotherapy Efficacy - A Pooled Analysis of the RAMONA, INTEGA, OPTIM, ELDORANDO, FORCE, TITAN-RCC and TITAN-TCC Trials of the German AIO Study Group.

British journal of cancer · 2026 · PMID 42156980

BACKGROUND: We explored the association of immune-related adverse events (irAE), along with prior and concomitant antibiotic and steroid use, on oncological outcomes following immune checkpoint inhibitor (ICI) treatment in various solid tumours. METHODS: Pooled data from seven trials on ICI therapy across multiple cancer types (head and neck, non-small cell lung cancer, gastroesophageal junctional adenocarcinoma, oesophageal, renal cell, and urothelial carcinoma) was analysed, focusing on overall survival (OS) and …

Enfortumab Vedotin-Induced Cutaneous Toxic Effects and Survival in Urothelial Carcinoma.

JAMA dermatology · 2026 · PMID 42525402

IMPORTANCE: Enfortumab vedotin (EV) is an antibody-drug conjugate approved for the treatment of locally advanced or metastatic urothelial cancer. Cutaneous adverse events (cAEs) are common during EV therapy, with prior studies suggesting an association between EV-related cAEs and improved survival; however, there are insufficient data to delineate the survival benefit of EV-induced cAEs from those associated with concurrent immune checkpoint inhibitors (ICIs). OBJECTIVE: To evaluate the association of EV-induced cA…

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…

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…

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…

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 …

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…

Deep Learning Analysis of Indocyanine Green Fluoroscopy of Ureters in Robotic Cystectomy: Toward Reducing Ureteroenteric Strictures.

Journal of endourology · 2026 · PMID 42159157

OBJECTIVES: To develop a deep learning method to quantify ureter perfusion during indocyanine green (ICG) fluoroscopy in robot-assisted radical cystectomy (RARC). INTRODUCTION: Ureteroenteric stricture (UES) is a common and clinically significant complication of RARC. Ureter ICG fluoroscopy likely reduces UES rates. However, its current reliance on subjective visual interpretation warrants a quantitative assessment method. MATERIALS AND METHODS: A single-center retrospective pilot study was performed using 96 video…

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…

Bladder cancer organoids: bridging pathological features and drug response for precision oncology.

International urology and nephrology · 2026 · PMID 41795761

Bladder cancer organoids (BCOs) represent a sophisticated three-dimensional pathological model that faithfully recapitulates the tissue architecture and molecular subtypes of parental tumors, thereby serving as a robust platform for investigating tumor heterogeneity and phenotypic plasticity. By establishing a functional bridge between pathological features and drug responses, BCOs not only enhance traditional morphological diagnoses but also predict patients' responses to chemotherapy, targeted therapy, and immuno…

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…

A case of canine urothelial carcinoma of the urinary bladder with skull and skeletal metastases.

Australian veterinary journal · 2026 · PMID 41992979

Canine urinary bladder neoplasia is uncommon, representing less than 1% of canine neoplasms. Amongst cases of urinary bladder neoplasia in dogs, primary urothelial carcinoma is the most frequent. Urothelial carcinomas are malignant invasive tumours which tend to be slow growing and metastasise late. However, the metastatic rate is high, with approximately 50% of cases developing metastases typically to the regional lymph nodes and lungs. Skeletal metastases are rare, with the most common reported sites being the fe…

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…

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…

Smart nanoplatform targeting the mitochondria-P-gp axis to overcome chemoresistance for synergistic bladder cancer therapy.

Colloids and surfaces. B, Biointerfaces · 2026 · PMID 42542000

Chemoresistance remains a major obstacle in bladder cancer therapy, driven by the interplay among P-glycoprotein (P-gp)-mediated drug efflux, mitochondrial metabolic reprogramming, and impaired apoptotic signaling. Here, we present a TME-responsive nanoplatform (DR@MPDA@M) composed of MPDA core shielded by manganese dioxide (MnO2) shell, enabling sequential co-delivery of doxorubicin and resveratrol for chemo-/chemodynamic/photothermal therapy. The MnO2 layer selectively degrades under the acidic and glutathione-ri…

Activation of the PI3K/AKT/mTOR signaling pathway in bladder cancer pathogenesis and its therapeutic significance.

Cancer treatment and research communications · 2026 · PMID 42537446

Bladder cancer is one of the most frequently observed cancer types globally. Urothelial bladder carcinoma (UBC) is the most common histologic subtype. Around 25% of patients present with muscle-invasive bladder cancer (MIBC) or metastatic disease, which are associated with poor prognosis. The PI3K/AKT/mTOR signaling pathway is an essential pathway for different cellular processes such as cell proliferation, survival, motility and metabolism. Aberrant activation of this pathway has been implicated in the development…

Preclinical Models of Bladder Cancer: Barrier, Metabolic, and Translational Susceptibility.

Pharmaceuticals (Basel, Switzerland) · 2026 · PMID 42515797

Preclinical bladder cancer models are often judged by tumor take, tumor growth or treatment inhibition, yet these endpoints do not reveal which bladder-specific constraints a given model preserves or bypasses. The bladder is shaped by a specialized urothelial barrier, urine exposure, cyclic filling and emptying, inflammatory injury, metabolic stress and intravesical treatment pressure. In this review, we use susceptibility engineering as an organizing framework for model selection and validation. We define suscepti…

Evodiamine alleviates cancer cachexia-induced muscle atrophy by inhibiting STAT3 signaling pathway.

European journal of pharmacology · 2026 · PMID 42508712

Cancer-associated cachexia (CAC) is a multifactorial syndrome characterized by progressive skeletal muscle and adipose tissue wasting, for which effective therapies remain limited. Here, we report that evodiamine (EVO), a bioactive alkaloid derived from Evodia rutaecarpa, markedly alleviates bladder cancer-associated cachexia in both in vivo and in vitro models. In T24 tumor-bearing mice, EVO significantly attenuated body weight loss and preserved skeletal muscle and fat mass without affecting primary tumor growth.…

Innovative In Vitro-In Silico Platform for Dose-Response Modeling in Canine Bladder Cancer: A 3D Organoid- and Mathematics-Based Approach.

The AAPS journal · 2026 · PMID 41851390

Approximately 25% of human urothelial carcinoma (UC) cases progress to high-grade, muscle-invasive bladder cancer (MIBC), for which treatment response remains difficult to predict. To address the need for more predictive platforms, we developed an integrated in vitro-in silico system using canine UC derived organoids, which closely mirror human MIBC at the histological, molecular, and clinical levels. Organoids were irradiated at doses of 0, 5, 9, or 15 Gy and cisplatin was administered at concentrations of 0, 10, …

DARS2 Promotes Bladder Cancer Progression by Enhancing PINK1-Mediated Mitophagy.

International journal of biological sciences · 2025 · PMID 39990673

Globally, bladder cancer is the tenth most common cancer. Mitophagy, a critical process regulating mitochondrial quantity and quality, has attracted increasing attention for its pivotal function in cancer. Nonetheless, its roles and underlying mechanisms in bladder cancer are yet to be elucidated. Therefore, in this study, 16 mitophagy-related genes were screened to construct a robust prognostic model with exceptional predictive accuracy for the outcomes of patients with bladder cancer. Of these genes, DARS2 was id…

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…

ELK1-YBX1 signaling promotes cisplatin resistance via ferroptosis adaptation in bladder cancer.

Cellular signalling · 2026 · PMID 42229737

Bladder cancer (BC) is one of the most common malignancies of the urinary system, and chemoresistance remains a major obstacle limiting the clinical efficacy of cisplatin-based chemotherapy. Elucidating the mechanisms underlying cisplatin resistance may facilitate the identification of potential therapeutic targets and ultimately improve patient outcomes. In this study, we found that Y-box binding protein 1 (YBX1) was upregulated in bladder cancer tissues with poor chemotherapeutic response as well as in cisplatin-…

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…

Organoid transcriptomics identifies IFIT-associated immune modulation during cryptotanshinone treatment for cancer.

New biotechnology · 2026 · PMID 42134537

Bladder cancer (BC), particularly muscle-invasive or metastatic disease, remains a major clinical challenge despite advances in immunotherapy. In this study, five candidate small molecules were screened, and cryptotanshinone (CTS) was identified as the most promising compound. Using BC cell lines and bladder tumor organoids, we evaluated the effects of CTS on proliferation, migration, apoptosis, and organoid growth. Transcriptomic sequencing of bladder tumor organoids, combined with protein-protein interaction anal…

In-situ cascade assembled peptide-drug conjugate for the treatment of bladder cancer by enhancing membrane-entry and lysosome destabilization.

Biomaterials · 2026 · PMID 42372507

Peptide-drug conjugates (PDC) have recently garnered substantial attention as promising strategies for targeted tumor therapy. However, the clinical efficacy of PDC is limited by poor membrane permeability and inherent lysosomal sequestration. Herein, we report an in-situ cascade assembled peptide-drug conjugate (ISCA-PDC) accomplished by integrating CXCR4-targeting cyclic peptide (Cyclo(DTyr-NMe-DOrn-Arg-2Nal-Gly)), a lysosomal-triggered assembled peptide linker (VEALYL) decorated with pH-sensitive moiety (cis-aco…

UCA1 facilitates endometriosis progression through EIF4A3-mediated stabilization of E2F1 mRNA and enhanced glycolysis.

Cellular signalling · 2026 · PMID 42235624

Long non-coding RNA Urothelial carcinoma-associated 1 (UCA1) is a pivotal regulator in the progression of endometriosis (EMs), yet its mechanistic role remains elusive. This study identified UCA1 as a factor promoting glycolysis through bioinformatic screening and functional validation. Ectopic endometrial lesions exhibited significant UCA1 upregulation compared to normal endometrial tissues. In ectopic endometrial stromal cells, UCA1 knockdown suppressed glycolytic activity, evidenced by diminished glucose uptake …

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 …

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…

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…

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…

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…

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 …

ctDNA-guided immunotherapy following radical cystectomy for muscle-invasive bladder cancer: results from the TOMBOLA trial.

Annals of oncology : official journal of the European Society for Medical Oncology · 2026 · PMID 41544704

BACKGROUND: Standard treatment of localized muscle-invasive bladder cancer (MIBC) is neoadjuvant chemotherapy (NAC) followed by radical cystectomy (RC), but ∼50% of patients relapse within 2 years. Adjuvant immunotherapy is currently administered based on pathology and clinical assessment in high-risk patients only, potentially resulting in under- and overtreatment. PATIENTS AND METHODS: TOMBOLA is a Danish, multicenter, open-label, single-arm phase II trial evaluating serial circulating tumor DNA (ctDNA) testing t…

Camrelizumab Plus Nab-paclitaxel in Patients with Previously Treated Advanced Urothelial Carcinoma: A Multicenter Phase II Study.

Cancer communications (London, England) · 2026 · PMID 42021969

Background: Immune checkpoint inhibitor (ICI) plus nab-paclitaxel has emerged as a promising strategy for advanced urothelial carcinoma (aUC). This study investigates the efficacy and safety of camrelizumab combined with nab-paclitaxel in patients with aUC who had progressed following first-line treatment. Methods: This multicenter, phase II study enrolled patients with aUC who had previously received at least 1 platinum-based therapy. Patients with prior ICI-based therapies were also included. Participants receive…

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…

PIK3CB Inhibitor GSK2636771 in Cancers With PTEN Mutation/Deletion or Loss of PTEN Protein Expression: Results From the NCI-MATCH ECOG-ACRIN Trial (EAY131) Subprotocols N and P.

JCO precision oncology · 2025 · PMID 40865033

PURPOSE: PTEN loss contributes to aberrant signaling of the phosphatidylinositol 3-kinase (PI3K)/protein kinase B/mammalian target of rapamycin pathway and may confer sensitivity to therapies targeting the PI3K pathway. The PIK3CB inhibitor GSK2636771 demonstrated efficacy in tumors with PIK3CB mutations and may similarly show efficacy in patients with PTEN loss. METHODS: Two nonrandomized, open-label phase II subprotocols within the context of the NCI-MATCH trial targeted PTEN tumor alterations in patients with ad…

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 …

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…

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…

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…

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…

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…

Neoadjuvant Nivolumab with or without Ipilimumab for Cisplatin-Ineligible Patients with Muscle-Invasive Bladder Cancer.

Clinical cancer research : an official journal of the American Association for Cancer Research · 2026 · PMID 41627171

PURPOSE: Many patients with muscle-invasive bladder cancer (MIBC) are ineligible for cisplatin-based therapy. We conducted a phase II trial of neoadjuvant nivolumab ± ipilimumab for cisplatin-ineligible patients. PATIENTS AND METHODS: Patients with MIBC were enrolled in two consecutive cohorts: (i) nivolumab alone and (ii) ipilimumab/nivolumab. A third cohort with alternative dosing was planned. The primary endpoint was eligibility for cystectomy ≤60 days after last treatment. Correlative analyses were performed, w…

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…

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 …

Urinary Biomarkers Objectively Measure Minimal Residual Disease in Non-Muscle-Invasive Bladder Cancer.

Clinical cancer research : an official journal of the American Association for Cancer Research · 2026 · PMID 41661209

PURPOSE: To determine whether carcinoma in situ (CIS) is a sufficient measure of minimal residual disease (MRD) in non-muscle-invasive bladder cancer (NMIBC) and evaluate alternative measures of MRD. EXPERIMENTAL DESIGN: We evaluated the concordance of CIS on transurethral resection of bladder tumor (TURBT) and radical cystectomy (RC) to determine eradication rates of clinical CIS (cCIS) by TURBT alone and rates of occult pathologic CIS (pCIS) seen only in RC specimens. We studied a prospective cohort of patients w…

A small-molecule inverse agonist of PPARγ for advanced solid tumors: a phase 1 trial.

Nature medicine · 2026 · PMID 41760953

Peroxisome proliferator-activated receptor gamma (PPARγ) is a master regulator of luminal lineage in urothelial carcinoma. FX-909 is a first-in-class oral small-molecule PPARγ inverse agonist. Here we report the first part of FX-909-CLINPRO-1, a phase 1A 3 + 3 dose-escalation study of FX-909, that enrolled 56 patients with advanced solid tumors, including 46 with urothelial carcinoma. The primary end point was safety and tolerability; secondary end points included recommended phase 2 dose determination, pharmacokin…

The circulating proteome and cancer risk: a systematic literature review and meta-analysis of 26 prospective studies with genetic validation.

EBioMedicine · 2026 · PMID 41512676

BACKGROUND: Proteins have an integral role in cancer aetiology and inform cancer detection, treatment, and prognosis. While published data from prospective proteomic studies identifying early detection cancer risk markers have rapidly increased in the past five years, the landscape of evidence remains unclear. We aim to synthesise the evidence on circulating proteins and cancer risk. METHODS: We conducted a systematic review and meta-analysis. We searched Embase and Medline up to December 2023 with reference-list s…

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…

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…

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…

Impact of perioperative nutrition on recovery after radical cystectomy: a randomised trial.

BJU international · 2026 · PMID 41310935

OBJECTIVE: To assess the effect of structured perioperative nutritional optimisation on complication rates, recovery metrics, and body composition in patients undergoing radical cystectomy (RC) with urinary diversion. PATIENTS AND METHODS: In this prospective, randomised controlled trial, 74 patients scheduled for RC were allocated to either a nutritional optimisation group (NOG, n = 37) receiving individualised pre- and postoperative dietary interventions, or a standard care group (SCG, n = 37). Protocol included …

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…

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…

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 …

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…

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…

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 …

Site and number of metastases predict outcomes in avelumab maintenance for advanced UC: results from meet-URO 25.

Cancer immunology, immunotherapy : CII · 2026 · PMID 41689638

BACKGROUND: In advanced urothelial carcinoma (UC), the prognostic impact of metastatic site and burden during avelumab maintenance therapy remains poorly defined. METHODS: We performed a sub-analysis of the Italian multicenter retrospective-prospective observational study Meet-URO 25, including patients with advanced UC who received avelumab maintenance after disease control with first-line platinum-based chemotherapy. We assessed the association between metastatic site and number of metastatic sites at the start o…

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…

Prospective multicenter study of ctDNA versus tumor tissue guiding FGFR-targeted therapy in metastatic urothelial cancer.

Nature communications · 2026 · PMID 41760649

Fibroblast growth factor receptor (FGFR) alterations are targetable in metastatic urothelial carcinoma (mUC). Identifying FGFR alterations currently requires tissue testing, which is limited by sample availability and cancer heterogeneity. Plasma circulating tumor DNA (ctDNA) offers a complementary testing strategy, but the added value of ctDNA relative to conventional FGFR alteration assessment remains unclear. Here, in a prospective, multicentre study, we show that ctDNA testing has high concordance with tissue F…

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…

Radical cystectomy practice patterns in the Nordic countries: results from the prospective NorCys study.

Scandinavian journal of urology · 2026 · PMID 41884949

BACKGROUND: Muscle invasive bladder cancer (MIBC) is an aggressive disease with a high mortality rate. Radical cystectomy (RC) is the standard treatment for MIBC and selected non-muscle invasive bladder -cancer (NMIBC) cases. The NorCys-study (NCT04523038, NCT04537221 and NCT04523025) aims to validate biomarkers predicting RC outcomes. This report describes RC practice patterns across the Nordic countries. MATERIALS AND METHODS: This prospective, multi-institutional study included bladder cancer patients undergoing…

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…

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 …

Quality of Life After Radical Cystectomy: Meta-analysis of Neobladder and Ileal Conduit Outcomes Across Multiple Assessment Tools.

European urology open science · 2026 · PMID 42028123

BACKGROUND AND OBJECTIVE: Radical cystectomy (RC) requires urinary diversion, commonly orthotopic neobladder (ONB) or ileal conduit (IC). While ONB preserves natural voiding, IC is technically simpler. This study aimed to compare long-term (>12 mo) quality of life (QoL) outcomes between ONB and IC to aid preoperative shared decision-making. METHODS: Following PRISMA guidelines, we searched PubMed, Cochrane Library, and Google Scholar up to September 15, 2025. We included studies comparing ONB and IC in adults with …

Systems Biology and Multi-Omics Determinants of Response to Bladder-Preserving Trimodality Therapy in Muscle-Invasive Bladder Cancer.

Life (Basel, Switzerland) · 2026 · PMID 42195381

Trimodality therapy (TMT)-maximal transurethral resection of bladder tumor (TURBT) followed by concurrent chemoradiotherapy-can offer oncologic outcomes comparable to radical cystectomy (RC) in carefully selected muscle-invasive bladder cancer (MIBC) patients while preserving the bladder and, possibly, the quality of life. Systematic reviews and long-term series support durable bladder-intact survival in responders, yet there is still a significant percentage of patients who exhibit incomplete response or invasive …

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…

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…

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…

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…

A Study to Evaluate Efficacy and Safety of Hydeal Cyst Intravesical Instillations in Non-muscle Invasive Bladder Cancer Patients Treated With Intravesical Chemotherapy or Immunotherapy.

European urology open science · 2026 · PMID 42004832

In non-muscle-invasive bladder cancer (NMIBC), patients undergo adjuvant local therapies such as chemotherapy (mitomycin C [MMC]) or immunotherapy (Bacillus Calmette-Guérin [BCG]) to reduce the risk of relapse and local/systemic progression. The main issue related to these topic therapies is their toxicity that is mainly local with rare systemic events. Hyaluronic acid is recommended in cases where it is necessary to restore and/or protect the layer of glycosaminoglycans damaged by local therapies. The Hydeal Cyst …

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…

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…

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…

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…

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…

Cost-effectiveness analysis of transurethral resection of bladder tumor with photodynamic diagnosis with 5-aminolevulinic acid hydrochloride for non-muscle invasive bladder cancer.

Photodiagnosis and photodynamic therapy · 2026 · PMID 42069032

OBJECTIVE: Photodynamic diagnosis (PDD)-assisted transurethral resection of bladder tumor (TURBT) is effective for preventing recurrence in patients with non-muscle invasive bladder cancer (NMIBC). However, the cost of PDD-TURBT is higher than that of standard white-light TURBT (WL-TURBT), given the use of photodynamic devices and 5-aminolevulinic acid hydrochloride (ALA). Accordingly, we evaluated the cost-effectiveness of PDD-TURBT with ALA. METHODS: This retrospective cohort study included patients with NMIBC wh…

Assessing Treatment Outcomes of Patients Undergoing Enfortumab Vedotin Dose Reduction in Metastatic Bladder Cancer.

Clinical genitourinary cancer · 2026 · PMID 41904052

INTRODUCTION: Enfortumab vedotin (EV) has emerged as a key treatment for metastatic bladder cancer. The treatment paradigm is to treat until unacceptable toxicity or progression, but acute and cumulative toxicity adversely impacts quality of life (QOL). We hypothesized that dose reductions may improve QOL without sacrificing efficacy. We conducted a single-center, retrospective study to assess association of EV dose reduction with treatment duration, treatment-related adverse events (TRAEs), and survival. METHODS: …

A Retrospective Follow-up Study on the Effects of Different Intravesical Treatments on Recurrence Control and Quality of Life in Patients With Non-Muscle-Invasive Bladder Cancer After Transurethral Resection of Bladder Tumour.

Archivos espanoles de urologia · 2026 · PMID 42265962

BACKGROUND: This study aimed to compare the mid-to long-term effects of pirarubicin chemotherapy and Bacillus Calmette-Guérin (BCG) immunotherapy on recurrence control, bladder function and health-related quality of life in patients with non muscle-invasive bladder cancer (NMIBC) after transurethral resection of bladder tumour (TURBT). METHODS: This retrospective cohort study comprised 126 patients with NMIBC who underwent TURBT followed by intravesical therapy between January 2018 and December 2023. Patients recei…

Comparison Study of Inverted-Nipple Ureteroneocystostomy and Direct Anastomosis in U-Shaped Orthotopic Neobladder Reconstruction.

Annals of surgical oncology · 2026 · PMID 42493711

BACKGROUND: Inverted-nipple ureteroneocystostomy (inverted-NU) is a novel technique for laparoscopic radical cystectomy with orthotopic neobladder reconstruction (LRC+ONB). For the traditional direct anastomosis (DA) technique, inverted-NU provides a more instructive clinical protocol. PATIENTS AND METHODS: Between 2020 and 2025, 84 patients were treated with LRC+ONB: 44 through inverted-NU and 40 through DA, respectively. Clinical features were compared including postoperative complications clinical symptoms, peri…

Impact of pelvic lymph node dissection on oncological outcomes in patients with clinically staged non-muscle-invasive bladder cancer undergoing radical cystectomy: A systematic review.

Critical reviews in oncology/hematology · 2026 · PMID 41655753

INTRODUCTION: In the majority of very high-risk and selected high-risk cases of clinically non-muscle-invasive bladder cancer (NMIBC), radical cystectomy (RC) may be performed. However, the necessity of pelvic lymph node dissection (PLND) in this clinical scenario is debated. The aim of this review was to evaluate how the presence and extent of PLND influence survival outcomes. MATERIALS AND METHODS: A systematic literature search was performed on July 6th, 2025, without language or time restrictions. Studies were …

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…

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…

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…

Extended versus standard lymph node dissection for urothelial carcinoma of the bladder in people undergoing radical cystectomy.

The Cochrane database of systematic reviews · 2026 · PMID 42023708

RATIONALE: We are currently uncertain of the benefits and harms of standard pelvic lymph node dissection (PLND) compared to extended PLND in the treatment of urothelial carcinoma of the bladder. OBJECTIVES: To assess the effects of extended versus standard PLND in people undergoing cystectomy to treat muscle-invasive (cT2 and cT4a) and treatment-refractory, non-muscle-invasive (cT1 with or without carcinoma in situ) urothelial carcinoma of the bladder. SEARCH METHODS: We conducted a comprehensive literature search …

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…

Redefining standards: a comprehensive systematic review of practice changing advances in GU oncology from ASCO and ESMO 2025.

Frontiers in endocrinology · 2026 · PMID 41993992

BACKGROUND: The year 2025 has been a transformative moment in GU oncology, with paradigm-shifting clinical trial results presented at major conferences and rapidly published. These developments are recasting therapeutic standards across bladder, kidney, prostate, penile, and testicular cancers through novel mechanisms and refined personalization. OBJECTIVES: This systematic review aimed to identify, synthesize, and critically evaluate pivotal phase II and III randomized controlled trials presented at ASCO/ESMO 2025…

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…

FDA Approval Summary: Durvalumab for the Treatment of Adult Patients with Muscle-Invasive Bladder Cancer.

Clinical cancer research : an official journal of the American Association for Cancer Research · 2026 · PMID 41678313

On March 28, 2025, the U.S. Food and Drug Administration (FDA) approved durvalumab (Imfinzi, AstraZeneca) with gemcitabine and cisplatin as neoadjuvant treatment, followed by single-agent durvalumab as adjuvant treatment following radical cystectomy (RC), for adults with muscle-invasive bladder cancer (MIBC). Substantial evidence of effectiveness was obtained from NIAGARA (NCT03732677), a randomized, phase III, open-label trial in cisplatin-eligible patients with MIBC who had not received prior systemic chemotherap…

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…

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…

Bacillus Calmette-Guérin Plus Mitomycin Versus Bacillus Calmette-Guérin Alone for Bacillus Calmette-Guérin-naïve Non-muscle-invasive Bladder Cancer: A Randomised Phase 3 Trial (ANZUP 1301).

European urology · 2026 · PMID 41633899

BACKGROUND AND OBJECTIVE: Intravesical bacillus Calmette-Guérin (BCG) plus mitomycin (MM) had not been compared rigorously with BCG alone in BCG-naïve, non-muscle-invasive bladder cancer (NMIBC) patients. METHODS: Participants with BCG-naïve NMIBC (high-grade pTa or any grade pT1; concurrent carcinoma in situ [CIS] allowed) were assigned randomly (1:1) to either the BCG + MM or the BCG-alone group after maximal transurethral resection. The primary endpoint was disease-free survival (DFS); the secondary endpoints in…

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…

Enfortumab Vedotin and Pembrolizumab in Cisplatin-Eligible Bladder Cancer.

The New England journal of medicine · 2026 · PMID 42485627

BACKGROUND: Neoadjuvant cisplatin-based chemotherapy is a standard therapy for muscle-invasive bladder cancer. The efficacy and safety of neoadjuvant and adjuvant (perioperative) enfortumab vedotin-pembrolizumab as compared with neoadjuvant cisplatin-based chemotherapy in persons with this cancer are unclear. METHODS: We conducted a phase 3, open-label, randomized trial involving adults with muscle-invasive bladder cancer eligible for cisplatin-based chemotherapy and radical cystectomy with pelvic lymph-node dissec…

Avelumab first-line maintenance for advanced urothelial carcinoma: long-term outcomes from the JAVELIN Bladder 100 trial in patients with high body mass index or diabetes mellitus.

ESMO open · 2026 · PMID 42284622

BACKGROUND: Avelumab first-line maintenance is the recommended treatment option for patients with advanced urothelial carcinoma (UC) without progression following platinum-based chemotherapy (PBC), based on the phase III JAVELIN Bladder 100 trial. High body mass index (BMI; ≥30 kg/m2) and diabetes mellitus (DM) are risk factors for bladder cancer. We report exploratory analyses from JAVELIN Bladder 100 in patients with high BMI or documented controlled DM at the time of random assignment. PATIENTS AND METHODS: JAVE…

Perioperative Enfortumab Vedotin and Pembrolizumab in Bladder Cancer.

The New England journal of medicine · 2026 · PMID 41707170

BACKGROUND: Patients with muscle-invasive bladder cancer who are ineligible for cisplatin-based chemotherapy proceed directly to radical cystectomy with pelvic lymph-node dissection. Perioperative therapy may improve outcomes in this population. METHODS: In this phase 3, open-label trial, participants with muscle-invasive bladder cancer who were ineligible for or declined cisplatin-based chemotherapy were randomly assigned to perioperative (neoadjuvant and adjuvant) enfortumab vedotin, an antibody-drug conjugate di…

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…

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…

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 …

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…

Enfortumab Vedotin and Pembrolizumab in Cisplatin-Eligible Bladder Cancer.

The New England journal of medicine · 2026 · PMID 42485627

BACKGROUND: Neoadjuvant cisplatin-based chemotherapy is a standard therapy for muscle-invasive bladder cancer. The efficacy and safety of neoadjuvant and adjuvant (perioperative) enfortumab vedotin-pembrolizumab as compared with neoadjuvant cisplatin-based chemotherapy in persons with this cancer are unclear. METHODS: We conducted a phase 3, open-label, randomized trial involving adults with muscle-invasive bladder cancer eligible for cisplatin-based chemotherapy and radical cystectomy with pelvic lymph-node dissec…

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…

Intravesical cretostimogene grenadenorepvec oncolytic immunotherapy in high-risk, BCG-unresponsive, non-muscle-invasive bladder cancer with carcinoma in situ (BOND-003 Cohort C): a single-arm, phase 3 trial.

The Lancet. Oncology · 2026 · PMID 42508433

BACKGROUND: There are few bladder-sparing treatment options for high-risk, BCG-unresponsive, non-muscle-invasive bladder cancer that are effective and have a manageable adverse event profile. Cretostimogene grenadenorepvec (hereafter, cretostimogene) is an oncolytic immunotherapy with dual mechanisms of action-it replicates in and lyses cancer cells with retinoblastoma-E2F pathway alterations and amplifies the immune response. We evaluated the response and safety/tolerability of cretostimogene in patients with high…

UGN-102 for Recurrent Low-Grade Intermediate-Risk Nonmuscle-Invasive Bladder Cancer: 24-Month Duration of Response Results From the Phase 3 ENVISION Trial.

The Journal of urology · 2026 · PMID 41880645

PURPOSE: We report the duration of response to UGN-102 treatment in patients with recurrent low-grade intermediate-risk nonmuscle-invasive bladder cancer (LG-IR-NMIBC) 24 months after achieving complete response (CR). MATERIALS AND METHODS: ENVISION is an ongoing, multinational, single-arm, phase 3 study in patients with biopsy-proven recurrent LG-IR-NMIBC. Patients received 6 once-weekly intravesical instillations of UGN-102. Patients underwent cystoscopy, urine cytology testing, and for-cause biopsy to determine …

Single, early intravesical instillation of pirarubicin in the prevention of bladder recurrence after radical nephroureterectomy for upper tract urothelial carcinoma (JCOG1403): a multicentre, open-label, randomised, phase 3 trial.

The Lancet. Oncology · 2026 · PMID 42435772

BACKGROUND: A previous phase 2 trial of single, postoperative intravesical instillation of pirarubicin after radical nephroureterectomy for upper tract urothelial carcinoma showed promising results in reducing the risk of bladder recurrence. We aimed to further evaluate the efficacy and adverse events of pirarubicin in this setting compared with the standard-of-care treatment of no intravesical instillation. METHODS: We did a multicentre, open-label, randomised, phase 3 trial (JCOG1403) with a two-stage registratio…

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,…

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…

INtraVESical immunoTherapy (INVEST) prior to radical cystectomy for bladder cancer: trial protocol.

BJU international · 2026 · PMID 42515859

BACKGROUND: High-risk non-muscle-invasive bladder cancer (HRNMIBC) has a variable prognosis, managed predominantly by local surgical resection and intravesical Bacillus Calmette-Guérin (BCG), or radical cystectomy (RC). Current treatments are poorly tolerated, have supply limitations and often fail to control the disease. Treatments overcoming these limitations are needed to improve HRNMIBC outcomes. Many novel agents have been approved in recent years (including systemic pembrolizumab, nogapendekin alfa inbakicept…

Holmium laser en‑bloc vs bipolar and conventional monopolar TURBT for non‑muscle‑ınvasive bladder cancer.

International urology and nephrology · 2026 · PMID 41579322

PURPOSE: This study aimed to compare the clinical safety, surgical efficacy, and oncologic outcomes of three transurethral resection techniques: the conventional monopolar transurethral resection of bladder tumor (CM-TURBT), the bipolar transurethral resection of bladder tumor (BP-TURBT), and the holmium laser en bloc resection of bladder tumor (HoL-ERBT) in patients with primary non-muscle-invasive bladder cancer (NMIBC). METHODS: This retrospective single-center cohort study included consecutive patients with pri…

PIK3CB Inhibitor GSK2636771 in Cancers With PTEN Mutation/Deletion or Loss of PTEN Protein Expression: Results From the NCI-MATCH ECOG-ACRIN Trial (EAY131) Subprotocols N and P.

JCO precision oncology · 2025 · PMID 40865033

PURPOSE: PTEN loss contributes to aberrant signaling of the phosphatidylinositol 3-kinase (PI3K)/protein kinase B/mammalian target of rapamycin pathway and may confer sensitivity to therapies targeting the PI3K pathway. The PIK3CB inhibitor GSK2636771 demonstrated efficacy in tumors with PIK3CB mutations and may similarly show efficacy in patients with PTEN loss. METHODS: Two nonrandomized, open-label phase II subprotocols within the context of the NCI-MATCH trial targeted PTEN tumor alterations in patients with ad…

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…

Real-World Efficacy and Safety of Frontline Enfortumab Vedotin Plus Pembrolizumab in Metastatic Urothelial Carcinoma: A Multicenter Study and Review of the Literature.

Clinical genitourinary cancer · 2026 · PMID 42349378

BACKGROUND: Enfortumab vedotin plus pembrolizumab (EV + P) is an established standard of care for metastatic urothelial carcinoma; however, real-world data remain limited. We evaluated clinical outcomes in patients treated in the frontline metastatic setting. PATIENTS AND METHODS: The primary endpoint was objective response rate (ORR); secondary endpoints included overall survival (OS), progression-free survival (PFS), duration of response, and safety. Median follow-up and survival outcomes were estimated using rev…

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…

Effectiveness and Safety of Enfortumab Vedotin Plus Pembrolizumab for Patients Aged 80 Years and Older With Metastatic Urothelial Carcinoma: A Multicenter Retrospective Study.

Anticancer research · 2026 · PMID 42527056

BACKGROUND/AIM: Enfortumab vedotin plus pembrolizumab (EVP) has become the standard first-line treatment for metastatic urothelial carcinoma (mUC); however, evidence regarding its use in very elderly patients remains limited. We evaluated the effectiveness and safety of EVP in patients aged ≥80 years with mUC. PATIENTS AND METHODS: This multicenter retrospective study included 60 patients with mUC treated with EVP at six institutions in Japan between September 2024 and March 2026. Patients were stratified into two …

A small-molecule inverse agonist of PPARγ for advanced solid tumors: a phase 1 trial.

Nature medicine · 2026 · PMID 41760953

Peroxisome proliferator-activated receptor gamma (PPARγ) is a master regulator of luminal lineage in urothelial carcinoma. FX-909 is a first-in-class oral small-molecule PPARγ inverse agonist. Here we report the first part of FX-909-CLINPRO-1, a phase 1A 3 + 3 dose-escalation study of FX-909, that enrolled 56 patients with advanced solid tumors, including 46 with urothelial carcinoma. The primary end point was safety and tolerability; secondary end points included recommended phase 2 dose determination, pharmacokin…

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…

Perioperative therapy in muscle-invasive bladder cancer: real-world evidence from the MINOTAURO study.

ESMO real world data and digital oncology · 2026 · PMID 42518717

BACKGROUND: Radical cystectomy with neoadjuvant and/or adjuvant therapy is the standard treatment of muscle-invasive urothelial cancer (MIUC). Although perioperative immunotherapy use has expanded, real-world data remain limited. The MINOTAURO study evaluated perioperative treatment patterns and outcomes in Spain. PATIENTS AND METHODS: This retrospective, multicenter study included adults with MIUC treated at 17 hospitals in Northern and Eastern Spain (April 2022-June 2024). Clinical data were extracted from electr…

Aspirin or non-steroidal anti-inflammatory drug initiation and subsequent bladder cancer evaluation.

Journal of internal medicine · 2026 · PMID 42220091

BACKGROUND: Whether aspirin or non-aspirin non-steroidal anti-inflammatory drugs (NSAIDs) initiation may unmask unknown bladder cancers (BCs) by hematuria remains controversial. OBJECTIVES: To evaluate unmasking, we compared cystoscopy rates, BC prevalence at cystoscopy, and invasive stage prevalence at diagnosis in aspirin or NSAID initiators with never-users. METHODS: Using the Danish population-based registries, we identified all new aspirin or NSAID users in 2005-2023 and a matched never-using comparison cohort…

Differential effects of prior versus concomitant Steroid and Antibiotic Treatment on Immunotherapy Efficacy - A Pooled Analysis of the RAMONA, INTEGA, OPTIM, ELDORANDO, FORCE, TITAN-RCC and TITAN-TCC Trials of the German AIO Study Group.

British journal of cancer · 2026 · PMID 42156980

BACKGROUND: We explored the association of immune-related adverse events (irAE), along with prior and concomitant antibiotic and steroid use, on oncological outcomes following immune checkpoint inhibitor (ICI) treatment in various solid tumours. METHODS: Pooled data from seven trials on ICI therapy across multiple cancer types (head and neck, non-small cell lung cancer, gastroesophageal junctional adenocarcinoma, oesophageal, renal cell, and urothelial carcinoma) was analysed, focusing on overall survival (OS) and …

Enfortumab Vedotin-Induced Cutaneous Toxic Effects and Survival in Urothelial Carcinoma.

JAMA dermatology · 2026 · PMID 42525402

IMPORTANCE: Enfortumab vedotin (EV) is an antibody-drug conjugate approved for the treatment of locally advanced or metastatic urothelial cancer. Cutaneous adverse events (cAEs) are common during EV therapy, with prior studies suggesting an association between EV-related cAEs and improved survival; however, there are insufficient data to delineate the survival benefit of EV-induced cAEs from those associated with concurrent immune checkpoint inhibitors (ICIs). OBJECTIVE: To evaluate the association of EV-induced cA…

Timing-dependent skin toxicity phenotypes during enfortumab vedotin plus pembrolizumab therapy for advanced urothelial carcinoma.

International journal of clinical oncology · 2026 · PMID 42509450

BACKGROUND: Enfortumab vedotin plus pembrolizumab (EV/Pem) has improved the survival of patients with advanced urothelial carcinoma; however, many patients suffer treatment-related adverse events, particularly skin toxicity. This study aimed to clarify the clinical impact of skin-toxicity timing on treatment outcomes. METHODS: We retrospectively analyzed patients with advanced urothelial carcinoma treated with EV/Pem. Patients were categorized into three groups according to skin-toxicity timing: no rash, early-onse…

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…

Effectiveness of integrated nursing interventions in enhancing patient outcomes during postoperative intravesical instillation for non-muscle invasive bladder cancer: A comparative study.

Medicine · 2024 · PMID 38489732

This study aimed to investigate nursing strategies for patients with non-muscle invasive bladder cancer (NMIBC) undergoing postoperative intravesical instillation. We recruited 100 NMIBC patients from January 2017 to January 2022. Participants were randomly assigned to either the research group or the control group (n = 50 each) using random number tables. The control group received routine nursing interventions, while the research group received integrated nursing interventions. We compared and analyzed various pa…

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…

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.…

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…