Development of novel agents for bladder cancer

Traditional treatment options for bladder cancer include transurethral resection and intravesical Bacillus Calmette Guerin for early stage disease and cystectomy or radiation therapy (with or without chemotherapy) for muscle-invasive disease. Platinum-based chemotherapy improves patient outcomes in both the perioperative and metastatic setting. Despite an increase in new therapeutic options over the past decade for many cancer patients, similar advances in bladder cancer are limited. In recent years, an improved understanding of the molecular forces driving bladder cancer development and progression has unfolded. These discoveries create a set of innovative therapeutic opportunities in bladder cancer. This review examines novel anti-cancer agents currently in clinical trials with preclinical rationale to support evaluation in bladder cancer. In addition, strategies to match a patient's tumor to the most appropriate agent are discussed. This may provide a more rational approach to evaluating the role of emerging anti-cancer agents in bladder cancer.