Bladder cancer (BC) is the eleventh most diagnosed malignancy worldwide for both sexes and the sixth in men, representing a significant public health concern. It is a heterogeneous disease classified according to tumor invasion into the bladder wall, currently requiring invasive procedures (such as transurethral resection and biopsy) for accurate tumor-node-metastasis (TNM) cancer staging. Muscle-invasive bladder cancer (MIBC), defined by tumor infiltration into the muscularis propria, represents the most aggressive non-metastatic form. The standard of care for MIBC includes neoadjuvant chemotherapy (NAC) followed by radical cystectomy (RC) and lymphadenectomy. However, the absence of reliable, non-invasive methods to assess treatment response results in all patients undergoing surgery, regardless of whether a pathological response (pR) has been achieved, heavily compromising their quality of life. Therefore, predictive biomarkers of NAC response are critically needed to guide clinical decisions and personalize therapy. Given the increasing relevance of liquid biopsies, particularly urine-based assays for BC, this review examines the current landscape of urinary biomarkers studied for MIBC stratification and NAC response prediction. Furthermore, we highlight the existing gaps in the field and emphasize the necessity of expanding research into non-invasive urinary biomarkers to enable their future translation into clinical practice.
Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie. 2026 Jul 28 [Epub ahead of print]
Gisela de Miguel-García, Vicenç Ruiz de Porras, Miriam Font-Morón, Albert Font, Francesc E Borràs, Marta Clos-Sansalvador
REMAR-IGTP Group Germans Trias i Pujol Research Institute (IGTP) & Nephrology Department, University Hospital Germans Trias i Pujol (HUGTiP), Can Ruti Campus Badalona (Barcelona) Catalonia, Spain; Department of Biochemistry and Molecular Biology, Universitat Autònoma de Barcelona (UAB), Bellaterra, Spain., GRET and Toxicology Unit, Department of Pharmacology, Toxicology and Therapeutic Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, Barcelona 08028, Spain., REMAR-IGTP Group Germans Trias i Pujol Research Institute (IGTP) & Nephrology Department, University Hospital Germans Trias i Pujol (HUGTiP), Can Ruti Campus Badalona (Barcelona) Catalonia, Spain., Badalona Applied Research Group in Oncology (B·ARGO), Catalan Institute of Oncology, Camí de les Escoles, s/n, Badalona 08916, Spain; CARE Program, Germans Trias i Pujol Research Institute (IGTP), Camí de les Escoles, s/n, Badalona 08916, Spain; Medical Oncology Department, Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Badalona 08916, Spain., REMAR-IGTP Group Germans Trias i Pujol Research Institute (IGTP) & Nephrology Department, University Hospital Germans Trias i Pujol (HUGTiP), Can Ruti Campus Badalona (Barcelona) Catalonia, Spain; Department of Cell Biology, Physiology and Immunology Universitat de Barcelona (UB) Barcelona, Spain. Electronic address: ., REMAR-IGTP Group Germans Trias i Pujol Research Institute (IGTP) & Nephrology Department, University Hospital Germans Trias i Pujol (HUGTiP), Can Ruti Campus Badalona (Barcelona) Catalonia, Spain. Electronic address: .