Some people with muscle-invasive bladder cancer can benefit from systemic chemotherapy before they undergo radical cystectomy. Chemotherapy administered before the operation is called neoadjuvant chemotherapy, and its proven benefits include improved overall survival and a lower risk of having a recurrence of bladder cancer. However, "it still is not widely administered," says Trinity Bivalacqua, M.D. Ph.D., Director of Urologic Oncology. There are several reasons why, including concerns about delaying surgery, risk of potential side effects, and the uncertainty that it will be effective.

Two new studies by Hopkins investigators in Urology, Pathology, and Oncology, provide insight based on clinical and molecular data; this work was published in Urologic Oncology and PLOS ONE. The researchers identified novel biomarkers "easily detected from routine bladder biopsies," that can predict patients whose cancer is most likely to respond to this treatment, Bivalacqua says. "This new molecular- based test will help us identify bladder cancer patients who will benefit the most from chemotherapy before radical cystectomy."