European urology oncology最新文献

{"title":"Re: Niven Mehra, Emmanuel S. Antonarakis, Se Hoon Park, et al. Patient-reported Outcomes in KEYLYNK-010: Pembrolizumab plus Olaparib Versus Abiraterone or Enzalutamide. EurUrol Oncol. In press. https://doi.org/10.1016/j.euo.2025.04.018.","authors":"Isabel Heidegger","doi":"10.1016/j.euo.2025.07.017","DOIUrl":"https://doi.org/10.1016/j.euo.2025.07.017","url":null,"abstract":"","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":9.3,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145343857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Downstream Impact of Social Media Use and Variable Quality of Online Information About Prostate Cancer.","authors":"Stacy Loeb, Mariana Rangel Camacho, Tatiana Sanchez Nolasco, Nataliya Byrne, Adrian Rivera, LaMont Barlow, June M Chan, Scarlett Gomez, Aisha T Langford","doi":"10.1016/j.euo.2025.09.004","DOIUrl":"https://doi.org/10.1016/j.euo.2025.09.004","url":null,"abstract":"<p><p>Social media can benefit prostate cancer care through education and empowerment, but also have the potential for exposure to misinformation, leading to adverse health and/or economic impacts for patients and damaging the patient-physician relationship. Clinicians should promote digital health literacy and provide recommended sources of reliable online content for additional information.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":9.3,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145312742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic Thulium Laser Ablation with Disitamab Vedotin and Immunotherapy in High-risk Upper Tract Urothelial Carcinoma: A Prospective Pilot Study of a Novel Kidney-sparing Strategy.","authors":"Jianjun Ye, Zeyu Chen, Xinyang Liao, Shiyu Zhang, Xiang Tu, Qihao Wang, Lei Zheng, Kai Chen, Banghua Liao, Mengni Zhang, Yali Shen, Jiyan Liu, Shuang Zhang, Hanmei Zhang, Peng Zhang, Hao Zeng, Xiang Li, Qiang Wei, Yige Bao","doi":"10.1016/j.euo.2025.09.015","DOIUrl":"https://doi.org/10.1016/j.euo.2025.09.015","url":null,"abstract":"<p><strong>Background and objective: </strong>Kidney-sparing treatment (KST) is an emerging alternative to radical nephroureterectomy for selected patients with upper tract urothelial carcinoma (UTUC), particularly those with imperative indications. Our aim was to evaluate the efficacy and safety of a novel KST approach combining endoscopic thulium laser ablation (TLA) with perioperative systemic therapy (disitamab vedotin [DV] and an immune checkpoint inhibitor [ICI]; toripalimab or tislelizumab) in a carefully selected cohort of patients with localized high-risk UTUC.</p><p><strong>Methods: </strong>This single-center prospective pilot study conducted from June 2021 to February 2024 and enrolled patients with localized high-risk UTUC with HER2 expression. Patients underwent multimodal treatment comprising sequential induction therapy, endoscopic TLA, consolidation therapy, and maintenance therapy. Co-primary endpoints were local recurrence-free survival (LRFS) and conversion-free survival (CFS). Secondary endpoints included overall survival (OS), cancer-specific survival (CSS), metastasis-free survival (MFS), intravesical recurrence-free survival (IVRFS), renal function benefits, and therapy-related adverse events (TRAEs).</p><p><strong>Key findings and limitations: </strong>A total of 33 patients were enrolled. Median follow-up was 23 mo for those without death or salvage surgery. LRFS rates were 67% at 1 yr and 64% at 2 yr. HER2 positivity was identified as a candidate protective factor for local recurrence within the first year (odds ratio 0.12, 95% confidence interval 0.01-0.95; p = 0.042). The 2-yr survival rates were 94% for CFS, 88% for IVRFS,100% for MFS, 94% for OS, and 100% for CSS. A renal function benefit was observed within the first year after ablation. The 1-yr ureteral stricture rate was 12% and no grade >3 TRAEs were observed.</p><p><strong>Conclusions and clinical implications: </strong>The combination of endoscopic TLA with perioperative systemic therapy demonstrated promising efficacy and manageable safety in selected patients with localized high-risk UTUC. Our results suggest that there is potential for a paradigm shift in the management of this challenging patient population.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":9.3,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145312795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Not Just Longer, But Better Lives: Refining the Measurement of Health-related Quality of Life in Renal Cell Carcinoma.","authors":"Lisa M Wintner, Mieke Van Hemelrijck, Christian Beisland","doi":"10.1016/j.euo.2025.09.011","DOIUrl":"https://doi.org/10.1016/j.euo.2025.09.011","url":null,"abstract":"","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":9.3,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145307395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cambridge kidney One-Stop Mass Investigation Clinic (CkOSMIC): A Nonrandomised Feasibility Study.","authors":"Chiara Re, James P Blackmur, Teele Kuusk, Thomas J Mitchell, James N Armitage, Antony C P Riddick, Lorraine Starling, Hannah Fox, Vineetha Thankappan Nair, Sue Norman, Claire Gilby, James O Jones, Brent O'Carrigan, Tristan Barrett, Robert Bakewell, Teikchoon See, Nicholas Hilliard, Simon Hilliard, Akash Prashar, Nadeem Shaida, Alopa Malaviya, Sona Appukutty, Ana Silva, Elena Cresci, Anne Y Warren, Grant D Stewart","doi":"10.1016/j.euo.2025.09.007","DOIUrl":"https://doi.org/10.1016/j.euo.2025.09.007","url":null,"abstract":"<p><strong>Background and objective: </strong>Our aim was to evaluate the feasibility and outcomes of a one-stop renal mass biopsy (RMB) clinic at which same-day biopsy results were facilitated by the use of confocal microscopy.</p><p><strong>Methods: </strong>The Cambridge kidney One-Stop Mass Investigation Clinic (CkOSMIC) was established in January 2024. Patients underwent an ultrasound (US)-guided biopsy, and the sample was assessed via a confocal laser microscopy scan, which provided results within minutes. Traditional histopathology processing was also conducted. A historical cohort of patients who underwent RMB according to the standard pathology pathway was used as the comparator. We assessed the feasibility, safety, and diagnostic accuracy, as well as the acceptability among patients and clinicians.</p><p><strong>Key findings and limitations: </strong>Overall, CkOSMIC US-guided biopsy was conducted in 50 patients over a period of 12 mo, of whom 48 received a provisional diagnosis immediately. The sensitivity and specificity for identification of malignancy were 94% (29/31; 95% confidence interval [CI] 79-98%) and 100% (17/17; 95% CI 82-100%), respectively. There was complete agreement between confocal and final pathology for 91.7% (n = 44) of the patients, and partial concordance (cancer identified but equivocal histological subtype) for 8.3% (n = 4). Time from first consultation to a treatment decision, and time from biopsy to a treatment decision were significantly shorter in the CkOSMIC pathway (25 d, interquartile range [IQR] 15-42) than in the standard pathway (55 d, IQR 41-77; p < 0.001). Time from biopsy to a treatment decision was also significantly shorter in the CkOSMIC pathway (0 d) than in the standard pathway (24 d, IQR 17-34; p < 0.001). All participants were \"satisfied\" or \"very satisfied\" with the pathway.</p><p><strong>Conclusions and clinical implications: </strong>CkOSMIC was feasible and showed high sensitivity and specificity in diagnosing cancer, while being safe and acceptable. It allows cancer targets to be met, reduces hospital visits and potentially reduces anxiety of delays in forming a treatment plan.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":9.3,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145299395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Conundrum of Intermediate Risk in Localised Prostate Cancer: One Group, Many Realities.","authors":"Arthur Peyrottes, Guillaume Ploussard, Paul Sargos, Eric Barret, Michael Baboudjian","doi":"10.1016/j.euo.2025.09.017","DOIUrl":"https://doi.org/10.1016/j.euo.2025.09.017","url":null,"abstract":"<p><p>For intermediate-risk prostate cancer, definitions remain inconsistent and management varies. Greater precision is urgently needed via optimal use of existing tools and integration of emerging innovations to harmonise care and improve outcomes for this most common disease category.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":9.3,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145279288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intermediate-risk Non-muscle-invasive Bladder Cancer: Recommendations for Definitions, Risk Stratification, Management Strategies, and Clinical Trial Design from the International Bladder Cancer Group.","authors":"Roger Li, Patrick J Hensley, Marko Babjuk, Laura Bukavina, Sarah P Psutka, Seth P Lerner, Michael A O'Donnell, Yair Lotan, Kelly K Bree, Joan Palou Redorta, David J McConkey, Byron H Lee, Paramananthan Mariappan, Laura S Mertens, Mark S Soloway, Robert S Svatek, Wei Shen Tan, Stephen B Williams, Shilpa Gupta, Roger Buckley, Ashish M Kamat","doi":"10.1016/j.euo.2025.08.003","DOIUrl":"https://doi.org/10.1016/j.euo.2025.08.003","url":null,"abstract":"<p><strong>Background and objective: </strong>Intermediate-risk (IR) non-muscle-invasive bladder cancer (NMIBC) is a heterogeneous disease, and standardized definitions and risk-guided management are critical for appropriate patient care and clinical trial development.</p><p><strong>Methods: </strong>A global committee of bladder cancer experts developed IR-NMIBC recommendations. Working groups reviewed literature and drafted recommendations, which were voted on by International Bladder Cancer Group (IBCG) members using a modified Delphi process. During an August 2024 meeting, voting results and evidence were presented, and recommendations were refined. Final recommendations achieved >75% agreement.</p><p><strong>Key findings and limitations: </strong>The IBCG recommends inclusion of only low-grade (LG; G1 and G2) tumors in the IR-NMIBC category, risk stratified using the IBCG IR-NMIBC risk scoring system. Given the relatively indolent course and treatment burden of IR-NMIBC, therapeutic deintensification with active surveillance or office-based ablation is appropriate for select patients. Morbidity related to transurethral resection of a bladder tumor can be mitigated by forgoing restaging resection in completely resected LG tumors and not mandating muscularis propria sampling. Perioperative chemotherapy reduces recurrences, and additional adjuvant intravesical treatment should be risk stratified. Clinical trials evaluating novel IR-NMIBC therapies, including adjuvant and ablative designs, should incorporate patient-reported outcomes and risk-stratified controls. Ablative trials, as proof-of-concept studies for efficacy, require randomized controlled studies in the adjuvant setting to confirm superiority over the standard of care.</p><p><strong>Conclusions and clinical implications: </strong>The IBCG consensus recommendations provide practical guidance for clinical care and clinical trial design for patients with IR-NMIBC.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":9.3,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145274386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of [¹⁷⁷Lu]Lu-PSMA-617 in Patients with Metastatic Clear-cell Renal Cell Carcinoma: The Multicentre, Single-arm, Phase 2 RENALUT Trial.","authors":"Emmanuel Seront, Mehdi Bsilat, Karolien Goffin, Anne-Sophie Govaerts, Saskia Litière, Jedelyn Cabrieto, Bert Dhondt, Bertrand Tombal, Laurence Albiges","doi":"10.1016/j.euo.2025.09.003","DOIUrl":"https://doi.org/10.1016/j.euo.2025.09.003","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background and objective: &lt;/strong&gt;Angiogenesis-targeting tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs) are standard treatments for metastatic clear-cell renal cell carcinoma (ccRCC). However, therapeutic options remain limited after progression on these agents. Prostate-specific membrane antigen (PSMA) is highly expressed on the surface of endothelial cells in ccRCC, making radioligand therapy with [&lt;sup&gt;177&lt;/sup&gt;Lu]Lu-PSMA-617 a promising approach.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical trial design and timeframe: &lt;/strong&gt;RENALUT (NCT06783348) is a single-arm, open-label, phase 2 trial investigating the safety and efficacy of [&lt;sup&gt;177&lt;/sup&gt;Lu]Lu-PSMA-617 in metastatic ccRCC after TKI and ICI failure. Eligible patients must have PSMA-positive lesions on PSMA positron emission tomography imaging. Patients will receive four cycles of [&lt;sup&gt;177&lt;/sup&gt;Lu]Lu-PSMA-617 every 6 wk, with up to two additional cycles in cases with stable disease or a partial response.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Endpoints: &lt;/strong&gt;The primary endpoint is the objective response rate according to Response Evaluation Criteria in Solid Tumours version 1.1.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data sources and statistical analysis plan: &lt;/strong&gt;Assuming a PSMA negativity rate of 15%, a total of 56 patients will be screened to achieve the target enrolment of 48 patients. European centres from three countries (Belgium, France, and Spain) will participate. First patient enrolment is expected in September 2025.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Strengths and limitations: &lt;/strong&gt;This is the first multicentre trial to assess PSMA-targeted radioligand therapy for patients with metastatic ccRCC selected on the basis of PSMA expression, which may be a potential biomarker in this setting.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Funding: &lt;/strong&gt;RENALUT is funded by Novartis and is being conducted as a research collaboration trial. The trial is sponsored by the EORTC.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Ethics and trial registration: &lt;/strong&gt;The trial has been approved by the ethics committee of the coordinating institution in the lead country (Belgium) and is registered on ClinicalTrials.gov as NCT06783348. Twelve centres across three countries will be participating. Regulatory submissions are ongoing at all participating sites in compliance with national requirements. Enrolment will begin only after all required approvals are in place.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Patient summary: &lt;/strong&gt;This trial is looking at a new treatment, called [&lt;sup&gt;177&lt;/sup&gt;Lu]Lu-PSMA-617, for patients with advanced kidney cancer that has spread and no longer responds to standard inhibitor and immunotherapy treatments. [&lt;sup&gt;177&lt;/sup&gt;Lu]Lu-PSMA-617 is a radioactive agent that targets a molecule called PSMA (prostate-specific membrane antigen). Patients who have PSMA detected on a PET (positron emission tomography) scan will receive the treatment every 6 weeks for up to four cycles, with the possibility of two extra cycles if their cancer is stable or shrinking. The aim of the trial is to test a n","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":9.3,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145274334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Kidney, Liver, and Immune Function on Circulating Tumor DNA Detection in Muscle-invasive Bladder Cancer.","authors":"Deema Radif, Sia Viborg Lindskrog, Iver Nordentoft, Karin Birkenkamp-Demtröder, Jørgen Bjerggaard Jensen, Mads Agerbæk, Lars Dyrskjøt","doi":"10.1016/j.euo.2025.09.012","DOIUrl":"https://doi.org/10.1016/j.euo.2025.09.012","url":null,"abstract":"<p><strong>Background and objective: </strong>The kidneys and liver play key roles in the metabolism of circulating molecules, including nucleic acids. To advance the clinical utility of circulating tumor DNA (ctDNA), it is essential to examine factors potentially affecting plasma ctDNA levels, including those influencing the clearance of cell-free DNA and ctDNA. This study evaluated the associations between plasma ctDNA detection and biochemical markers indicative of kidney and liver function, and leukocyte-based immune function and inflammation in patients with muscle-invasive bladder cancer (MIBC), along with their prognostic potential.</p><p><strong>Methods: </strong>A tumor-informed plasma ctDNA analysis was conducted for 276 MIBC patients treated at Aarhus University Hospital. Biochemical measurements collected within 10 d of available ctDNA tests were retrieved from electronic health records. Statistical analyses included multivariable logistic and linear regression models, and false discovery rate correction.</p><p><strong>Key findings and limitations: </strong>Significant associations between kidney or liver function markers and ctDNA detection were not observed. Leukocyte count (odds ratio [OR] = 1.29 [95% confidence interval: 1.07; 1.54]), neutrophil count (OR = 1.50 [1.17; 1.92]), and neutrophil-to-lymphocyte ratio (OR = 4.01 [1.85; 8.71]) were significantly associated with ctDNA detection. Associations between biochemical parameters and pathological downstaging or recurrence were not observed. Limitations include the nonconcurrent timing of biochemical and ctDNA measurements.</p><p><strong>Conclusions and clinical implications: </strong>This study shows no evidence that plasma ctDNA detection is affected by kidney/liver function, ensuring the reliability of using ctDNA to monitor MIBC patients. Elevated leukocyte-based immune markers were observed in ctDNA-positive patients, but the evaluated biochemical parameters showed no prognostic value. Further studies are warranted to confirm these findings.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":9.3,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145274339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revisiting Neoadjuvant Chemotherapy in Cisplatin-eligible Muscle-invasive Bladder Cancer.","authors":"Javier Molina-Cerrillo, James Catto, Ashish M Kamat, Andrea Necchi, Morgan Roupre T, Enrique Grande","doi":"10.1016/j.euo.2025.09.006","DOIUrl":"https://doi.org/10.1016/j.euo.2025.09.006","url":null,"abstract":"<p><strong>Background and objective: </strong>Management of muscle-invasive bladder cancer (MIBC) is evolving rapidly due to advances in systemic therapies and molecular understanding. Neoadjuvant cisplatin-based chemotherapy remains the cornerstone of cisplatin-eligible patients, supported by strong evidence of improved overall survival and pathological complete response. Phase 3 trials such as VESPER and NIAGARA have refined the standard of care by demonstrating the benefits of dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin combination and chemoimmunotherapy, respectively. This review aims to summarize current and emerging neoadjuvant strategies and outline future directions toward a more individualized approach.</p><p><strong>Methods: </strong>We reviewed the recent literature and pivotal clinical trial data evaluating neoadjuvant therapies for MIBC, with a focus on systemic chemotherapy, immunotherapy, combination regimens, novel agents, and biomarker-driven approaches. Emerging bladder-preserving strategies were also examined.</p><p><strong>Key findings and limitations: </strong>Neoadjuvant cisplatin-based chemotherapy remains the established benchmark; however, the NIAGARA trial has provided the first phase 3 evidence supporting neoadjuvant chemoimmunotherapy as a new therapeutic option. The addition of durvalumab to cisplatin-based chemotherapy resulted in a significant improvement in survival and response endpoints. Antibody-drug conjugates and biomarkers such as circulating tumor DNA and DNA damage response mutations are shaping a more personalized treatment paradigm. However, optimal regimen selection, sequencing of therapies, and robust methods for response assessment remain unresolved.</p><p><strong>Conclusions and clinical implications: </strong>Recent therapeutic advances, particularly the integration of immunotherapy, novel agents, and biomarker-driven strategies, are redefining the neoadjuvant landscape in MIBC. Neoadjuvant treatment for MIBC is moving toward a biomarker-informed risk-adapted approach, integrating novel agents and multidisciplinary decision-making. Refinement of patient selection and treatment sequencing will be critical to improving outcomes and advancing personalized, precision-based care.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":9.3,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}