Abstract
In this plain language podcast, the authors discuss highlights from the American Urological Association (AUA) Annual Meeting 2025. These insights come from the perspective of an expert patient and physician, both of whom have experience and expertise in the field of bladder cancer. This podcast is intended to broaden the reach of complex data and insights from AUA 2025 to a broader audience, including non-specialists, helping enable better informed treatment decisions between patients and healthcare professionals. The authors introduce the current treatment landscape for patients and discuss four clinical trials focusing on patients with bacillus Calmette-Guérin (BCG)-naïve and BCG-unresponsive high-risk non-muscle invasive bladder cancer (HR-NMIBC). Three trials presenting novel treatment approaches and their impact on survival and disease progression are discussed: PD-1 inhibitors in combination with BCG, a first-in-use intravesical drug delivery system that targets treatment directly to the bladder, and a novel oncolytic tumor-directed therapy. Authors highlight the strengths and limitations of these novel mechanisms vs standard of care, including convenient and more accessible treatment, similar or more effective disease response, and safety profiles. Finally, a prospective observational trial comparing patient quality of life outcomes is discussed, highlighting the differences between patients receiving bladder preservation vs radical cystectomy, the current gold standard of treatment. Key data from AUA showcase the growing number of treatment options available to patients with BCG-naïve and BCG-unresponsive HR-NMIBC and present promising new agents and broader possibilities for existing agents. They also raise the continued need for a nuanced approach towards navigating bladder preservation and the importance of shared-decision-making and goals of care discussions between patients and their physicians when discussing care. Podcast (MP4 122704 kb).