What new standards of care were found in a 2025 review of bladder cancer trials?
A 2025 systematic review of randomized controlled trials identified several new standards of care for bladder cancer. These include perioperative durvalumab (a type of immunotherapy), the combination of enfortumab vedotin (an antibody-drug conjugate) plus pembrolizumab (an immunotherapy), and HER2-targeted therapy with disitamab vedotin plus toripalimab. These advances are changing how bladder cancer is treated, particularly for muscle-invasive and advanced stages.
What the research says
A 2025 systematic review of 40 randomized controlled trials in genitourinary cancers identified key advances in bladder cancer treatment 5. For muscle-invasive bladder cancer, the review highlighted perioperative durvalumab (from the NIAGARA trial) and the combination of enfortumab vedotin plus pembrolizumab (from KEYNOTE-905/EV-303) as new standards 5. Additionally, HER2-targeted therapy with disitamab vedotin plus toripalimab (from RC48-C016) improved outcomes for metastatic disease 5. These findings are supported by the 2025 European Association of Urology guidelines, which emphasize a multidisciplinary approach and shared decision-making 9. The guidelines also note new recommendations for diagnosis, treatment, and follow-up of muscle-invasive and metastatic bladder cancer 9. Other 2025 research has explored active surveillance for high-grade T1 bladder cancer, finding it noninferior to BCG therapy in a highly selected patient population 1. However, this approach is not yet a standard of care. For non-muscle-invasive bladder cancer, new options like TAR-200, UGN-102, nadofaragene firadenovec, and immune checkpoint inhibitors are emerging, but ongoing trials will determine their role 10.
What to ask your doctor
- Could perioperative durvalumab be an option for my muscle-invasive bladder cancer?
- Is the combination of enfortumab vedotin and pembrolizumab appropriate for my stage of disease?
- Am I a candidate for HER2-targeted therapy with disitamab vedotin and toripalimab?
- What are the potential benefits and side effects of these new treatments compared to standard care?
- How do the 2025 EAU guidelines apply to my specific situation?
This question is drawn from common patient questions about Oncology and answered using cited medical research. We do not provide individualized advice.