New treatments for superficial bladder cancer.

The successful treatment of bladder cancer remains a challenge for urologists and oncologists. Substantial changes have been made in the therapeutic options for the management of superficial bladder cancer in the past 5 years. We review the preclinical and clinical developments over the past year in bladder cancer therapeutics. A growing trend involves the use of multimodality treatments for all bladder cancers. For superficial disease, intravesical instillation of chemotherapeutic agents after transurethral resection is quickly becoming the standard of care. Novel therapeutic modalities under investigation include DNA vaccines, magnetically targeted carriers, bioadhesive microspheres, and antisense oligodeoxynucleotides. Treatment goals for superficial bladder cancer are complete removal of the initial tumor, prevention of disease recurrence, and inhibition of progression to invasive disease. The myriad novel therapeutic modalities under exploration suggest that these goals may be achievable within our lifetime.