For those of us who take care of patients with the sixth most common malignancy in the United States and the seventh most common cause of cancer-related death,it was disheartening that, as recently as 2015, patients with advanced bladder cancer had no effective alternatives to cisplatinum-based chemotherapy, a status quo that had persisted for three decades.2

Adding to this, patients who had tumors that did not respond to BCG therapy also had no true alternative other than radical cystectomy.3

Over the last 2 years, we have seen rapid progress in the bladder cancer arena, with an explosion of clinical trials across all disease states. Five PD-1 and PD-L1 checkpoint inhibitors are now FDA-approved for the treatment of metastatic urothelial cancer, while a fibroblast growth factor receptor (FGFR) inhibitor and an antibody-drug conjugate each have received breakthrough designation status.4-10 Soon, results from additional registration trials are expected to further expand our options for treating both early-stage and advanced disease. This rapidly evolving landscape is incredibly exciting, but also creates a challenge as busy physicians struggle to keep track of numerous pivotal studies that have or will read out over such a compressed timeframe.

The figures and summary by Noah Hahn, MD, are an invaluable map of these trials and resulting approvals.11 I thank Noah for collating these many trials and presenting them in such a clear and updatable manner. Any investigator whose bladder cancer trial is not shown in the figures and who would like their trial included is invited to email UroToday at . We welcome your additions and feedback.