Bladder cancer is the 11th most common cancer in the UK, with around 10,300 new cases and 5,400 deaths annually. Treatment has been transformed in recent years by checkpoint inhibitors, antibody-drug conjugates (ADCs) like enfortumab vedotin, and FGFR3-targeted therapies. UK centres are running trials across all stages — from BCG-unresponsive non-muscle-invasive disease to metastatic urothelial carcinoma.
UK bladder cancer research is coordinated through the NCRI Bladder and Renal Cancer Clinical Studies Group. Major trial centres include the Royal Marsden, the Christie, and centres in Leeds, Birmingham, and Glasgow. NICE has approved atezolizumab, pembrolizumab, avelumab, nivolumab, and enfortumab vedotin for various bladder cancer indications.
There are currently over 40 actively recruiting bladder cancer trials in the UK, spanning NMIBC, MIBC, and metastatic settings.
Types of Bladder Cancer Trials
Immunotherapy
Checkpoint inhibitors (anti-PD-1/PD-L1) for metastatic disease, maintenance therapy after chemotherapy, and BCG-unresponsive NMIBC.
Antibody-Drug Conjugates
Enfortumab vedotin (Padcev) targeting Nectin-4, and sacituzumab govitecan targeting TROP2 — delivering chemotherapy directly to cancer cells.
FGFR-Targeted
Erdafitinib and other FGFR inhibitors for FGFR2/3-mutant urothelial cancer — a precision medicine approach for ~20% of patients.
Novel Combinations
ADC + immunotherapy, dual checkpoint blockade, and novel intravesical therapies for non-muscle-invasive disease.
Metastatic Urothelial Cancer Trials
Enfortumab vedotin + pembrolizumab — the EV-302 trial established this combination as a new first-line standard for metastatic urothelial cancer. UK trials now exploring: biomarker selection, treatment duration, and real-world outcomes
Second-line immunotherapy — pembrolizumab and atezolizumab after platinum chemotherapy progression. UK trials testing: earlier use, combination with other agents, and biomarkers predicting response
Maintenance immunotherapy — avelumab maintenance after first-line platinum-based chemotherapy (JAVELIN Bladder 100), now standard of care with UK trials optimising patient selection
FGFR inhibitor therapy — erdafitinib for FGFR2/3-altered urothelial cancer. UK trials testing: use after immunotherapy, combination with immunotherapy, and earlier treatment lines
Novel ADCs — next-generation antibody-drug conjugates with different payloads and targets, in UK Phase 1/2 trials for previously treated metastatic disease
Muscle-Invasive Bladder Cancer (MIBC)
Neoadjuvant immunotherapy — checkpoint inhibitors before cystectomy (bladder removal), with UK trials testing pathological complete response rates and long-term outcomes
Neoadjuvant chemotherapy + immunotherapy — combining standard dose-dense MVAC or gemcitabine/cisplatin with anti-PD-1 to improve pathological response rates
Trimodality therapy — transurethral resection + radiotherapy + chemotherapy as bladder-preserving treatment, with UK trials adding immunotherapy to this approach
Adjuvant immunotherapy — nivolumab after surgery for high-risk MIBC (CheckMate 274), with UK trials testing duration and combination approaches
Non-Muscle-Invasive Bladder Cancer (NMIBC)
BCG-unresponsive trials — for patients whose cancer returns after BCG treatment. Options include intravesical chemotherapy, gene therapy (nadofaragene firadenovec), immunotherapy, and novel intravesical agents
Percutaneous immunotherapy — ALT-803 (N-803) with BCG for BCG-unresponsive carcinoma in situ, in UK Phase 3 trials
Intravesical drug delivery — new formulations and delivery systems for better drug retention and penetration in the bladder wall
Surveillance optimisation — trials using urinary biomarkers and photodynamic diagnosis to reduce the frequency of invasive cystoscopies
Who Can Participate?
Metastatic trials — histologically confirmed urothelial carcinoma, measurable disease, treatment-naïve or after specific prior therapy, adequate organ function for chemotherapy if required
MIBC trials — resectable or unresectable muscle-invasive disease, adequate performance status, suitable for surgery and/or radiotherapy
NMIBC trials — confirmed non-muscle-invasive disease, BCG-refractory or BCG-unresponsive (for most trials), recurrent high-grade disease
FGFR trials — require confirmed FGFR2 or FGFR3 mutation or fusion (tested via next-generation sequencing)
General criteria — ECOG 0-2, adequate bone marrow/liver/kidney function, no untreated CNS metastases
UK Bladder Cancer Trial Locations
London — Royal Marsden Hospital, UCLH, Guy's and St Thomas', Barts Health
Manchester — The Christie NHS Foundation Trust
Leeds — St James's University Hospital
Birmingham — Queen Elizabeth Hospital Birmingham
Glasgow — Beatson West of Scotland Cancer Centre
Southampton — University Hospital Southampton
🧬 Tip: Request FGFR Testing
About 20% of urothelial cancers carry FGFR2 or FGFR3 alterations. If you have metastatic bladder cancer, ask your oncologist about comprehensive genomic profiling — FGFR status determines eligibility for erdafitinib and other targeted therapies. PD-L1 testing is also important as it may inform immunotherapy decisions.
How to Find Your Match
Use our Smart Matcher to find bladder cancer trials tailored to your specific situation. Whether you are newly diagnosed, exploring targeted therapy, or seeking advanced treatment options, we can match you to actively recruiting studies.