Perioperative systemic therapy for bladder cancer.

PURPOSE OF REVIEW: Recent advances in research related to biomarkers and immunotherapy has the potential to transform the landscape for the use of perioperative systemic therapy in patients with bladder cancer. RECENT FINDINGS: Predictive biomarkers including DNA damage repair genes and gene expression profiling may soon lead to better selection of patients for neoadjuvant cisplatin-based chemotherapy. Success of immunotherapy for the treatment of metastatic bladder cancer has led to promising trials exploring immunotherapy in muscle-invasive disease. SUMMARY: Current trials employing predictive biomarkers as well as those using immunotherapy have the potential to significantly improve the outcome of patients with muscle-invasive bladder cancer.