Muscle-invasive bladder cancer is commonly treated with chemotherapy followed by radical cystectomy (complete removal of the bladder), a life-altering procedure that significantly affects quality of life. However, decades of clinical observations have shown that a substantial percentage of patients have no detectable cancer remaining at the time of surgery, raising critical questions about whether all patients require such aggressive treatment.

“Our goal is to move beyond a one-size-fits-all approach,” said Matthew D. Galsky, MD, Professor of Medicine (Hematology and Medical Oncology) at the Icahn School of Medicine, Deputy Director of the Mount Sinai Tisch Cancer Center, and first author of the study. “We are working toward a future where treatment decisions are guided by precise molecular tools that tell us which patients truly need surgery, and which patients may be cured without losing their bladder.”