Neoadjuvant treatment patterns and biomarker selection in muscle-invasive bladder cancer
Abstract As the feasibility of risk-adaptive bladder-sparing treatment is increasingly validated, the prospects for neoadjuvant therapy in muscle-invasive bladder cancer (MIBC) are rapidly evolving. For patients seeking effective and tolerable treatment options, platinum-based chemotherapy, particul...
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| Format: | Article |
| Language: | English |
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Springer
2025-07-01
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| Series: | Discover Oncology |
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| Online Access: | https://doi.org/10.1007/s12672-025-02796-6 |
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| author | Wei He Jiaxin Xie Ziwei Wang Maoyu Wang Qing Chen Chen Zhang Yue Wang Xufeng Yu Yi Wang Hui Zhang Xuncheng Yang Zhensheng Zhang Chuanliang Xu Shuxiong Zeng |
| author_facet | Wei He Jiaxin Xie Ziwei Wang Maoyu Wang Qing Chen Chen Zhang Yue Wang Xufeng Yu Yi Wang Hui Zhang Xuncheng Yang Zhensheng Zhang Chuanliang Xu Shuxiong Zeng |
| author_sort | Wei He |
| collection | DOAJ |
| description | Abstract As the feasibility of risk-adaptive bladder-sparing treatment is increasingly validated, the prospects for neoadjuvant therapy in muscle-invasive bladder cancer (MIBC) are rapidly evolving. For patients seeking effective and tolerable treatment options, platinum-based chemotherapy, particularly dose-dense MVAC (ddMVAC), remains the preferred standard. However, the emergence of novel interventions such as immune checkpoint inhibitors (ICIs), FGFR inhibitors, and antibody–drug conjugates (ADCs) offers promising alternatives, especially for those ineligible for cisplatin-based regimens. Ongoing clinical trials, including KEYNOTE-B15, RC48-C017, and NIAGARA, are actively investigating the efficacy of combining these agents with existing neoadjuvant therapies, aiming to establish new first-line treatment options. Although predictive models based on histological features, DNA damage repair (DDR) genes, molecular subtyping, liquid biopsies, and in vitro organoids have demonstrated potential in guiding treatment selection, the clinical translation process remains slow. There is a pressing need to accelerate the exploration of genetic heterogeneity in MIBC and to validate the clinical utility of emerging biomarkers to optimize patient selection for neoadjuvant therapy. This review will comprehensively examine the evolution of neoadjuvant treatment paradigms, focusing on high-quality evidence from evidence-based medicine and translational clinical research, with the aim of enhancing and updating readers' knowledge of neoadjuvant therapy for MIBC and providing insights for future practice and research directions. |
| format | Article |
| id | doaj-art-dcacf8976b764d4daa56717d29c9d7af |
| institution | Kabale University |
| issn | 2730-6011 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Springer |
| record_format | Article |
| series | Discover Oncology |
| spelling | doaj-art-dcacf8976b764d4daa56717d29c9d7af2025-08-20T03:45:31ZengSpringerDiscover Oncology2730-60112025-07-0116112910.1007/s12672-025-02796-6Neoadjuvant treatment patterns and biomarker selection in muscle-invasive bladder cancerWei He0Jiaxin Xie1Ziwei Wang2Maoyu Wang3Qing Chen4Chen Zhang5Yue Wang6Xufeng Yu7Yi Wang8Hui Zhang9Xuncheng Yang10Zhensheng Zhang11Chuanliang Xu12Shuxiong Zeng13Department of Urology, The First Affiliated Hospital, Naval Medical UniversityDepartment of Urology, The First Affiliated Hospital, Naval Medical UniversityDepartment of Urology, The First Affiliated Hospital, Naval Medical UniversityDepartment of Urology, The First Affiliated Hospital, Naval Medical UniversityDepartment of Urology, The First Affiliated Hospital, Naval Medical UniversityDepartment of Urology, The First Affiliated Hospital, Naval Medical UniversityDepartment of Urology, The First Affiliated Hospital, Naval Medical UniversityDepartment of Urology, The First Affiliated Hospital, Naval Medical UniversityDepartment of Urology, The First Affiliated Hospital, Naval Medical UniversityDepartment of Urology, The First Affiliated Hospital, Naval Medical UniversityDepartment of Urology, The First Affiliated Hospital, Naval Medical UniversityDepartment of Urology, The First Affiliated Hospital, Naval Medical UniversityDepartment of Urology, Shanghai First People’s Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Urology, The First Affiliated Hospital, Naval Medical UniversityAbstract As the feasibility of risk-adaptive bladder-sparing treatment is increasingly validated, the prospects for neoadjuvant therapy in muscle-invasive bladder cancer (MIBC) are rapidly evolving. For patients seeking effective and tolerable treatment options, platinum-based chemotherapy, particularly dose-dense MVAC (ddMVAC), remains the preferred standard. However, the emergence of novel interventions such as immune checkpoint inhibitors (ICIs), FGFR inhibitors, and antibody–drug conjugates (ADCs) offers promising alternatives, especially for those ineligible for cisplatin-based regimens. Ongoing clinical trials, including KEYNOTE-B15, RC48-C017, and NIAGARA, are actively investigating the efficacy of combining these agents with existing neoadjuvant therapies, aiming to establish new first-line treatment options. Although predictive models based on histological features, DNA damage repair (DDR) genes, molecular subtyping, liquid biopsies, and in vitro organoids have demonstrated potential in guiding treatment selection, the clinical translation process remains slow. There is a pressing need to accelerate the exploration of genetic heterogeneity in MIBC and to validate the clinical utility of emerging biomarkers to optimize patient selection for neoadjuvant therapy. This review will comprehensively examine the evolution of neoadjuvant treatment paradigms, focusing on high-quality evidence from evidence-based medicine and translational clinical research, with the aim of enhancing and updating readers' knowledge of neoadjuvant therapy for MIBC and providing insights for future practice and research directions.https://doi.org/10.1007/s12672-025-02796-6Neoadjuvant therapyMuscle-invasive bladder cancerClinical trialsLiquid biopsy |
| spellingShingle | Wei He Jiaxin Xie Ziwei Wang Maoyu Wang Qing Chen Chen Zhang Yue Wang Xufeng Yu Yi Wang Hui Zhang Xuncheng Yang Zhensheng Zhang Chuanliang Xu Shuxiong Zeng Neoadjuvant treatment patterns and biomarker selection in muscle-invasive bladder cancer Discover Oncology Neoadjuvant therapy Muscle-invasive bladder cancer Clinical trials Liquid biopsy |
| title | Neoadjuvant treatment patterns and biomarker selection in muscle-invasive bladder cancer |
| title_full | Neoadjuvant treatment patterns and biomarker selection in muscle-invasive bladder cancer |
| title_fullStr | Neoadjuvant treatment patterns and biomarker selection in muscle-invasive bladder cancer |
| title_full_unstemmed | Neoadjuvant treatment patterns and biomarker selection in muscle-invasive bladder cancer |
| title_short | Neoadjuvant treatment patterns and biomarker selection in muscle-invasive bladder cancer |
| title_sort | neoadjuvant treatment patterns and biomarker selection in muscle invasive bladder cancer |
| topic | Neoadjuvant therapy Muscle-invasive bladder cancer Clinical trials Liquid biopsy |
| url | https://doi.org/10.1007/s12672-025-02796-6 |
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