A sea change has occurred in the treatment options available for metastatic urothelial bladder cancer with the recent Food and Drug Administration approval of 5 immune checkpoint blockade agents for patients who have progressed on platinum-based chemotherapy or are not candidates for cisplatin. Additionally, comprehensive characterization of the landscape of genomic alterations in this disease through The Cancer Genome Atlas and other efforts has detected numerous potential targets for small molecule inhibitors. Detailed analysis of the urothelial carcinoma transcriptome has allowed for molecular subtyping of the disease and the ramifications of these subtypes upon treatment response is an active area of investigation. Coupled with these advances is a critical unmet need to define predictive biomarkers of response to therapy. Here, we highlight select research relevant to the validation and continued discovery of novel biomarkers to advance precision oncology in bladder cancer.
