Your new experience awaits. Try the new design now and help us make it even better

REVIEW article

Front. Oncol.

Sec. Genitourinary Oncology

This article is part of the Research TopicBladder Cancer Awareness Month 2025: Current Developments and Insights in the Treatment of Bladder CancerView all 5 articles

Molecular mechanisms and translational advances in bladder cancer: from driver genes to precision therapy

Provisionally accepted
Jinjie  XiangJinjie XiangYuhui  LuoYuhui LuoBaiyu  ZhangBaiyu ZhangKunbin  KeKunbin KeHao  LiHao Li*
  • First Affiliated Hospital of Kunming Medical University, Kunming, China

The final, formatted version of the article will be published soon.

Bladder cancer is a highly heterogeneous malignant tumor of the urinary system with high recurrence rates, posing significant challenges in its diagnosis and treatment. Advances in multi-omics research have elucidated the molecular mechanisms underlying the pathogenesis and progression of bladder cancer, including driver gene mutations (e.g., FGFR3, TP53/RB1), dysregulation of signaling pathways (such as PI3K/AKT/mTOR and RAS-MAPK), epigenetic alterations, non-coding RNA networks, tumor microenvironment remodeling, and metabolic reprogramming. This review systematically summarizes recent progress in translational research bridging molecular mechanisms to breakthroughs in precision therapy, covering the clinical applications and challenges of FGFR inhibitors, immune checkpoint inhibitors, antibody-drug conjugates, and gene therapies. Translational efforts are increasingly relying on molecular subtyping to develop subtype-specific treatment strategies. Although significant advances have been made in precision therapy for bladder cancer, critical research gaps remain, including tumor heterogeneity, therapy resistance, and insufficient validation of biomarkers. Future research directions emphasize the potential of liquid biopsy for non-invasive diagnosis and dynamic monitoring, rational combination therapies, multi-omics data integration, and artificial intelligence in advancing personalized treatment, providing a systematic and forward-looking perspective on precision medicine in bladder cancer.

Keywords: Bladder cancer, Molecular mechanisms, translational medicine, precision therapy, targeted therapy

Received: 21 Jul 2025; Accepted: 24 Nov 2025.

Copyright: © 2025 Xiang, Luo, Zhang, Ke and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Hao Li

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.