Bladder articles from across Nature Portfolio

In this Perspective, the authors discuss the idea of targeting histone modifications in bladder cancer, providing a comprehensive overview of findings from preclinical and translational studies. Clinical trials in which the efficacy of molecules targeting histone modifiers was assessed in bladder cancer are also discussed.

Oxidative stress and reactive oxygen species contribute to the pathophysiology of interstitial cystitis/bladder pain syndrome through their effects on molecular pathways. Here, the authors discuss these pathways, animal models of interstitial cystitis/bladder pain syndrome and treatment options for the disease.

In the SELENIB trial, selenium and vitamin E were compared with placebo as chemoprevention for non-muscle-invasive bladder cancer (NMIBC). No difference versus placebo was observed in recurrence-free interval (RFI) with selenium, but vitamin E was associated with worse RFI. Selenium and vitamin E cannot be recommended in chemoprevention for NMIBC. Furthermore, patients with NMIBC taking supplemental vitamin E should be made aware of its potential association with worse RFI.

Oligometastatic bladder cancer, defined as a cancer with limited metastases, is a potential target for curative metastasis-directed therapy in a multidisciplinary framework. The consensus definition of oligometastatic bladder cancer is a valuable starting point for clinical trials, but challenges remain in accurately characterizing metastatic burden with current imaging modalities and determining optimal strategies to treat patients with lymph node involvement.

The heterogeneous nature of non-muscle-invasive bladder cancer is a challenge for clinical trial design. Careful consideration in clinical trial design, choice of end points and adequate patient characterization is important when evaluating new therapies.

Clinic-based uroflowmetry is limited by a short window of data collection and inefficient data transmission. Obtaining uroflowmetry data in the home setting has the potential for increased data on voiding patterns to inform clinical decision-making. However, integration of this practice depends on optimizing technology and data management.