The changing treatment paradigm for patients with bladder cancer

After decades of relative therapeutic standstill, the introduction of new treatment modalities including antibody-drug-conjugates, immune checkpoint inhibitors and targeted therapies are causing a dramatic change in the treatment paradigm for patients with bladder cancer. While the most profound impact of these new treatment modalities is currently seen in patients with advanced, or metastatic disease, these agents will likely also penetrate the treatment algorithms for earlier disease stages in the years to come. This article provides a brief overview of the contemporary, medical management of bladder cancer, with a particular focus on the innovative treatment modalities that have recently emerged for patients with locally advanced and metastatic disease. In doing so we assess how the recently updated treatment guidelines for bladder cancer formulated by the European Society of Medical Oncology (ESMO) and the European Urology Association (EAU) can be translated to clinical practice, taking into consideration the Belgium reimbursement landscape.