Bladder cancer treatment has moved beyond chemotherapy alone, with immunotherapy, antibody-drug conjugates, and FGFR-targeted pills extending life in advanced disease. For early-stage tumors confined to the bladder lining, new options are giving patients alternatives to bladder removal when standard treatments fail.
What's actually going on in research
Trials are testing immunotherapy combinations as first-line treatment, antibody-drug conjugates earlier in the disease course, and bladder-preserving approaches that combine chemotherapy and radiation. Researchers are also studying treatments for non-muscle-invasive bladder cancer that resists BCG therapy, and biomarkers that guide treatment choice.
Antibody-drug conjugates
Drugs like enfortumab vedotin deliver chemotherapy directly to bladder cancer cells. Combinations with immunotherapy are now first-line for advanced disease.
Bladder preservation
For some muscle-invasive cancers, combining chemotherapy and radiation can avoid bladder removal while achieving similar survival. Trials are refining who is a candidate.
BCG-resistant disease
New treatments — including gene therapy and immunotherapy delivered into the bladder — are giving options to patients whose superficial cancer keeps returning despite BCG.
What to know before you search
Eligibility often depends on whether the cancer is non-muscle-invasive or muscle-invasive, prior treatments, and specific genetic features like FGFR mutations.
What types of trials are currently open
- Treatment trials — Testing new drugs or combinations in people with bladder cancer to see if they extend life or work in resistant disease.
- Surgical trials — Comparing surgical approaches and bladder-preserving strategies for muscle-invasive cancer.
- Adjuvant trials — Testing treatments given after surgery to lower the chance of recurrence.
- Bladder-instilled therapy trials — Testing new treatments delivered directly into the bladder for non-muscle-invasive cancer.
- Observational studies — Following people with bladder cancer to understand outcomes and identify markers that predict response.
Recently added Bladder Cancer trials
Study on the Effects of Drugs That Modulate the Endocannabinoid System on Spontaneous and Induced Contractility of the Human Detrusor Muscle
The goal of this observational, in vitro study is to evaluate the effects of drugs that modulate the endocannabinoid system on spontaneous and neuronally induced contractility of the human detrusor. The study will include adult patients undergoing elective radical cystectomy for bladder cancer. The main questions it aims to answer are whether modulation of endocannabinoid receptors, enzymes involved in endocannabinoid synthesis and degradation, and endocannabinoid transport mechanisms alters basal detrusor contractility and modifies excitatory motor responses induced by neuronal activation. Participants undergoing radical cystectomy will provide written informed consent for the collection of a small sample of macroscopically healthy bladder tissue from the surgical specimen. Detrusor muscle strips will be prepared and studied in vitro using organ bath techniques. Contractile activity will be recorded under baseline conditions and after electrical field stimulation, as well as following exposure to pharmacological modulators of the endocannabinoid system. Demographic, clinical, and pathological data will also be collected for descriptive analysis.
Bladder EpiCheck Product Development Study
This is a prospective, observational study to support the development of the Bladder EpiCheck kit by collecting urine samples from subjects suspected to have a bladder tumor or under NMIBC surveillance. This is a single visit study. Each subject will sign the informed consent and provide voided urine sample. Demography and, if performed, pathology information will be collected for each subject.
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