At the 2026 American Society of Clinical Oncology Genitourinary Cancers Symposium, researchers highlighted important progress in the treatment of bladder cancer, reflecting the meeting’s theme, “Patient-Centered Care: From Discovery to Delivery.” New study results showcased promising combination therapies that improved cancer control and, in some cases, expanded bladder-preserving options. Below are some of the key highlights from this event.
New research from Fox Chase Cancer Center shows that a simple blood test looking for circulating tumor DNA (ctDNA) may help predict whether muscle-invasive bladder cancer is likely to spread to other parts of the body. ctDNA are tiny fragments of DNA released by cancer cells, and patients who had no detectable ctDNA after treatment had better outcomes, whether or not they had their bladder removed. However, the test did not reliably detect cancer that came back only in the bladder, meaning patients still need careful monitoring with other tools.
By using ctDNA to better understand who is at higher risk for metastasis, doctors may be able to more safely select patients who can keep their bladder while still effectively treating their cancer.
Data shows that the combination of enfortumab vedotin (Padcev) and pembrolizumab (Keytruda) worked better than standard chemotherapy for patients with muscle-invasive bladder cancer who were able to receive surgery. Patients who received the dual therapy lived longer without their cancer returning. At two years, nearly 80% of patients on the new combination remained free of major cancer events, compared with about 66% on standard chemotherapy.
This research is important because it represents the first major improvement in pre-surgery treatment for muscle-invasive bladder cancer in nearly 25 years. It offers patients a new option that may lower the risk of recurrence and improve survival, potentially setting a new standard of care.
A phase 2 study found that a combination of sacituzumab govitecan (Trodelvy) and pembrolizumab (Keytruda) helped nearly 40% of patients with muscle-invasive bladder cancer achieve a complete clinical response, meaning no visible cancer on scans or biopsy. At one year, 74% of patients were free from cancer spreading, and outcomes were especially strong among those who had a complete response. Importantly, some patients were able to preserve their bladder instead of undergoing removal surgery.
The results suggest that newer treatments, like antibody-drug conjugates combined with immunotherapy, may offer an effective bladder-sparing option.
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