Bladder cancer treatment has come a long way in recent years. Thanks to ongoing research and clinical trials, doctors now have more options than ever to help patients live longer, experience fewer side effects, and maintain a better quality of life. From new drug combinations to innovative surgical techniques and diagnostic tools, here’s a guide to what’s new in bladder cancer care.

A game-changing combination: Enfortumab vedotin and pembrolizumab

One of the biggest breakthroughs in bladder cancer treatment is the FDA’s 2023 approval of a combination therapy using enfortumab vedotin (Padcev) and pembrolizumab (Keytruda). This treatment is now the first-line option for people with locally advanced or metastatic urothelial bladder cancer, a major shift in care. In clinical trials, this combination therapy reduced the risk of disease progression or death by 55% compared to traditional chemotherapy.

Advances in surgery: Single-port robotic cystectomy

For patients who need bladder removal surgery (cystectomy), new robotic techniques are helping make recovery easier. The single-port robotic cystectomy allows surgeons to remove the bladder and reconstruct it using just one small incision.

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Compared to traditional surgery, this approach tends to be less painful and have a quicker recovery. While more research is still underway, early results are promising for patients with both muscle-invasive and treatment-resistant non-muscle-invasive bladder cancer.

Immune checkpoint inhibitors with other therapies

Immunotherapy helps your body’s own immune system recognize and attack cancer cells. These drugs, known as immune checkpoint inhibitors, have already changed how doctors treat advanced bladder cancer. Not all patients are a fit for immunotherapies. Researchers today are examining whether there are specific biomarkers that can help identify which patients will respond to these drugs, if administering them in earlier stages of disease is beneficial, and if combining them with other therapies can lead to better outcomes. 

Targeted therapy: Zeroing in on cancer genes

Targeted therapy attacks specific genetic changes that allow cancer cells to grow. The drug erdafitinib, approved in 2019, targets tumors with FGFR2 or FGFR3 gene alterations, which are found in about 20% of bladder cancers. Researchers are now studying erdafitinib in comparison with chemotherapy and immunotherapy to find the most effective approach for patients with these gene changes.

Antibody-drug conjugates: Precision treatment with fewer side effects

Antibody-drug conjugates (ADCs) are a new kind of treatment that deliver cancer-fighting drugs directly to tumor cells, helping spare healthy tissue.

The ADC enfortumab vedotin has already been approved for advanced bladder cancer. Studies show that combining it with pembrolizumab, a targeted therapy, can improve survival compared to chemotherapy alone. Researchers are also testing this combination in earlier stages of the disease.

An easier way to monitor recurrence

Bladder cancer has a high rate of recurrence, which means regular monitoring is critical. Traditionally, doctors use cystoscopy, a procedure that can be uncomfortable and invasive, to check for recurrence. Now, researchers are developing urine-based tests that could make follow-up care easier, more comfortable, and more accessible for patients.

The future of bladder cancer treatment

With ongoing research into combination therapies, new immunotherapies, and less invasive monitoring tools, the future of bladder cancer care is bright. Each new discovery helps doctors personalize treatment, improve survival, and enhance quality of life for patients.

If you or a loved one is living with bladder cancer, ask your care team about clinical trials or newly approved therapies that might be right for you.

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