Purpose of review The treatment landscape for advanced and non-muscle-invasive urothelial carcinoma (UC) is rapidly evolving beyond platinum chemotherapy and immune checkpoint inhibitors. This review is timely and relevant as it synthesizes recent, impactful data from 2024–2025 early-phase trials, highlighting agents poised to redefine clinical standards. Recent findings Recent studies showcase promising novel strategies. These include next-generation targeted therapies like sapanisertib, novel antibody–drug conjugates (ADCs) and bicycle toxin conjugates (BTCs) such as zelenectide pevedotin (BT8009) and dual-ADC combinations with high response rates, and the approved immunomodulator N-803 for BCG-unresponsive disease. Furthermore, innovative intravesical therapies, including ADCs (disitamab vedotin) and immune checkpoint inhibitors, show transformative potential for localized disease with favorable safety. Summary The findings indicate a shift towards more effective and tailored treatments. Future efforts must focus on biomarker validation, strategic sequencing, and managing combination toxicities to integrate these advances into practice and improve patient outcomes.
Lee et al. (Tue,) studied this question.