Anne E. Lizardi, DNP, CRNP, RNFA, presented “Bladder Cancer Current Treatment Landscape.”
How to cite: Lizardi, Anne E. “Bladder Cancer Current Treatment Landscape.” October 2025. Accessed Mar 2026. https://grandroundsinurology.com/bladder-cancer-current-treatment-landscape/
Bladder Cancer Current Treatment Landscape – Summary
Anne E. Lizardi, DNP, CRNP, RNFA, Johnson & Johnson Innovative Medicine, Philadelphia, Pennsylvania, discusses the current treatment landscape for bladder cancer, emphasizing risk stratification and evidence-based therapy selection. She notes that bladder cancer is the sixth most common malignancy in the United States and that management varies significantly between non-muscle invasive and muscle-invasive disease. Non-muscle invasive cases, including carcinoma in situ and Ta/T1 tumors, are treated with transurethral resection of the bladder tumor (TURBT). Bacillus Calmette-Guérin (BCG) therapy remains central for intermediate and high-risk disease.
For BCG-unresponsive disease, Dr. Lizardi outlines options such as radical cystectomy or alternative intravesical agents, including gemcitabine and mitomycin, and FDA-approved therapies like pembrolizumab, nadofaragene firadenovec, and nogapendekin alfa inbakicept. She reviews the American Urological Association (AUA) and National Comprehensive Cancer Network (NCCN) guideline definitions of BCG-refractory, relapsing, and intolerant disease, which determine patient eligibility for advanced therapies.
In muscle-invasive bladder cancer, radical cystectomy with pelvic lymph node dissection and neoadjuvant cisplatin-based chemotherapy is the preferred standard. For cisplatin-ineligible patients, bladder preservation strategies using chemoradiation may be considered. Adjuvant therapy options include nivolumab or pembrolizumab based on pathologic stage and prior therapy.
Dr. Lizardi also describes the growing role of biomarker-directed and molecular testing to guide targeted therapy, particularly FGFR2/3 alterations and HER2 positivity, while emphasizing multidisciplinary coordination and surveillance adherence to improve long-term outcomes.
ABOUT THE AUTHOR
Anne E. Lizardi, DNP, CRNP, RNFA, earned her Bachelor of Arts degree at the University of Pittsburgh and completed her nursing education and Doctor of Nursing Practice at Thomas Jefferson University. Since August 2023, Dr. Lizardi has been with Johnson & Johnson Innovative Medicine on the Immunology team and on the Genitourinary Oncology team, serving as a Medical Science Liaison.
