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Purpose of Review <p>This review examines the evolving landscape of non-muscle invasive bladder cancer (NMIBC) management, focusing on risk stratification, novel therapeutic strategies, and the integration of biomarkers into clinical care.</p> Recent Findings <p>Emerging genomic markers such as FGFR3 and TERT promoter mutations show promise for diagnosis and personalized treatment. Advances in immunotherapy, including the use of pembrolizumab and nadofaragene firadenovec, offer options for BCG-unresponsive NMIBC, though challenges like cost and adverse effects remain. Current guidelines emphasize stratified care based on risk, balancing treatment intensity with recurrence and progression risks.</p> Summary <p>While transurethral resection with intravesical therapy remains the standard for most NMIBC, early radical cystectomy is pivotal for select high-risk cases. Future directions highlight the need for biomarker-driven models to refine treatment paradigms, reduce overtreatment, and improve long-term outcomes. Continued clinical trials are essential to validate these approaches and address unmet needs in NMIBC care.</p>

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Advancements in the Diagnosis, Treatment, and Risk Stratification of Non-Muscle Invasive Bladder Cancer

  • 期刊论文

  • 发表日期：

    2025年2月20日

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  • Shayan Smani,
  • Julien DuBois,
  • Kai Zhao,
  • Ryan Sutherland,
  • Syed N. Rahman,
  • Peter Humphrey,
  • David Hesse,
  • Wei Shen Tan,
  • Darryl Martin,
  • Soum D. Lokeshwar,
  • Fady Ghali

摘要

Purpose of Review

This review examines the evolving landscape of non-muscle invasive bladder cancer (NMIBC) management, focusing on risk stratification, novel therapeutic strategies, and the integration of biomarkers into clinical care.

Recent Findings

Emerging genomic markers such as FGFR3 and TERT promoter mutations show promise for diagnosis and personalized treatment. Advances in immunotherapy, including the use of pembrolizumab and nadofaragene firadenovec, offer options for BCG-unresponsive NMIBC, though challenges like cost and adverse effects remain. Current guidelines emphasize stratified care based on risk, balancing treatment intensity with recurrence and progression risks.

Summary

While transurethral resection with intravesical therapy remains the standard for most NMIBC, early radical cystectomy is pivotal for select high-risk cases. Future directions highlight the need for biomarker-driven models to refine treatment paradigms, reduce overtreatment, and improve long-term outcomes. Continued clinical trials are essential to validate these approaches and address unmet needs in NMIBC care.