Condition

Bladder cancer

Clinical trials and treatment information for Bladder cancer

3M
People Affected
200
Active Trials
756K
New Cases/Year
222K
Deaths/Year

Treatment Rankings

Ranked by evidence volume first. Medicine has spent centuries ranking things by vibes. This is an improvement.

1
Radical Cystectomy
85% Effectiveness• 95% Confidence• 35% Safety• 270 trials• 30K participants
HIGH EvidenceGood Value
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Comparative Safety Scale(Higher is safer)

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35
DangerousModerateSafe

Time to Effect

immediate

Duration

One-time surgery + lifelong management of diversion

Response Rate

85%

Remission Rate

60%

Number Needed to Harm (NNH)

2

Common Side Effects:

Post-operative complications (infection, bleeding, ileus): 50%
Urinary diversion complications (stoma issues, metabolic acidosis): 30%
Sexual dysfunction (erectile dysfunction, vaginal shortening): 90%
Perioperative mortality: 3%

Annual Cost of Care

Drug Cost

$100,000

Monitoring

$7,000

Side Effects

$10,000

Total Annual

$117,000

Cost-Effectiveness

GOOD

QALYs Gained

3

ICER

$80,000/QALY

Cost per Remission

$195,000

Cost per Responder

$137,647.06

Treatment Outcomes
Primary Outcomes
5-Year Overall Survival Rate20% (for comparable muscle-invasive bladder cancer treated conservatively or with less effective approaches)
+225% (+45 percentage points)
5-Year Cancer-Specific Survival Rate25% (for comparable muscle-invasive bladder cancer treated conservatively or with less effective approaches)
+180% (+45 percentage points)
5-Year Local/Regional Recurrence Rate60% (for comparable muscle-invasive bladder cancer without radical cystectomy or with less effective treatment)
-75% (-45 percentage points)
Secondary Benefits
Urinary Functional Score (EORTC QLQ-BLM30 urinary subscale)85/100 (pre-surgery, typical function for aging population without active bladder cancer symptoms directly impacting this)
-35.3% (-30 points)
Sexual Activity Score (e.g., EORTC QLQ-C30 sexual functioning scale)70/100 (pre-surgery, accounting for age-related factors)
-57.1% (-40 points)
Body Image Score (EORTC QLQ-BLM30 body image subscale)80/100 (pre-surgery)
-37.5% (-30 points)
Common Side Effects
Post-operative complications (infection, bleeding, ileus)
+50%
Urinary diversion complications (stoma issues, metabolic acidosis)
+30%
Sexual dysfunction (erectile dysfunction, vaginal shortening)
+90%

Clinical Trial Phases:

Phase 4
2
BCG (Bacillus Calmette-Guérin) Intravesical Therapy
80% Effectiveness• 90% Confidence• 55% Safety• 24 trials• 20K participants
HIGH EvidenceGood ValueDose: 1 vial (50-80 mg) intravesically once a week for 6 weeks, then maintenance
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Comparative Safety Scale(Higher is safer)

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55
DangerousModerateSafe

Time to Effect

3-6 months

Duration

1-3 years (induction + maintenance)

Response Rate

75%

Remission Rate

70%

Number Needed to Treat (NNT)

5

Number Needed to Harm (NNH)

25

Common Side Effects:

Cystitis (bladder inflammation): 80%
Flu-like symptoms (fever, chills, malaise): 40%
Urinary frequency/urgency: 70%
Hematuria (blood in urine): 15%

Annual Cost of Care

Drug Cost

$15,000

Monitoring

$4,000

Side Effects

$1,500

Total Annual

$20,500

Cost-Effectiveness

GOOD

QALYs Gained

0.8

ICER

$55,000/QALY

Cost per Remission

$29,285.71

Cost per Responder

$27,333.33

Treatment Outcomes
Primary Outcomes
Response Rate62 Participants
-71% (-44.0 Participants)
Secondary Benefits
Percentage of Participants With Recurrence-free Survival After Complete Response
0%
Common Side Effects
Cystitis (bladder inflammation)
+80%
Flu-like symptoms (fever, chills, malaise)
+40%
Urinary frequency/urgency
+70%

Clinical Trial Phases:

Phase 4
3
Gemcitabine + Cisplatin Chemotherapy
70% Effectiveness• 90% Confidence• 25% Safety• 112 trials• 10K participants
HIGH EvidenceModerate ValueDose: Gemcitabine 1000-1250 mg/m² IV day 1, 8; Cisplatin 70 mg/m² IV day 1 or 2 every 3 weeks
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Comparative Safety Scale(Higher is safer)

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25
DangerousModerateSafe

Time to Effect

3-6 months

Duration

3-6 months (4-6 cycles)

Response Rate

45%

Remission Rate

12%

Number Needed to Treat (NNT)

7

Number Needed to Harm (NNH)

3

Common Side Effects:

Myelosuppression (neutropenia, thrombocytopenia): 70%
Nausea/Vomiting: 60%
Fatigue: 80%
Nephrotoxicity (kidney damage): 15%
Peripheral neuropathy: 15%

Annual Cost of Care

Drug Cost

$25,000

Monitoring

$7,500

Side Effects

$15,000

Total Annual

$47,500

Cost-Effectiveness

MODERATE

QALYs Gained

0.7

ICER

$120,000/QALY

Cost per Remission

$395,833.33

Cost per Responder

$105,555.56

Treatment Outcomes
Primary Outcomes
Overall Response Rate0% (no response)
+60% (60% of patients achieve objective tumor response)
Median Overall Survival8 months (historical/untreated metastatic bladder cancer)
+75% (+6 months (e.g., from 8 to 14 months))
Median Progression-Free Survival3.5 months (historical/untreated metastatic bladder cancer)
+100% (+3.5 months (e.g., from 3.5 to 7 months))
Pathological Complete Response Rate (Neoadjuvant)0% (no pCR)
+25% (25% of patients achieve pCR in resected specimen)
Secondary Benefits
EORTC QLQ-C30 Global Health Status/QoL Score60 points (on 0-100 scale, higher is better)
+8.3% (+5 points (e.g., from 60 to 65 points))
Pain Intensity Score (NRS 0-10)6 points (on 0-10 scale, higher is worse)
-25% (-1.5 points (e.g., from 6 to 4.5 points))
EORTC QLQ-C30 Fatigue Scale Score45 points (on 0-100 scale, higher is worse)
-11.1% (-5 points (e.g., from 45 to 40 points))
Common Side Effects
Myelosuppression (neutropenia, thrombocytopenia)
+70%
Nausea/Vomiting
+60%
Fatigue
+80%

Clinical Trial Phases:

Phase 4
4
Enfortumab Vedotin (Padcev)
70% Effectiveness• 90% Confidence• 40% Safety• 19 trials• 2K participants
HIGH EvidencePoor ValueDose: 1.25 mg/kg IV on days 1, 8, and 15 of a 28-day cycle
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Comparative Safety Scale(Higher is safer)

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40
DangerousModerateSafe

Time to Effect

1-3 months

Duration

Lifetime (or until progression)

Response Rate

45%

Remission Rate

12%

Number Needed to Treat (NNT)

4

Number Needed to Harm (NNH)

3

Common Side Effects:

Fatigue: 55%
Peripheral neuropathy: 45%
Rash/Skin reactions: 45%
Hyperglycemia: 15%

Annual Cost of Care

Drug Cost

$320,000

Monitoring

$7,500

Side Effects

$10,000

Total Annual

$337,500

Cost-Effectiveness

POOR

QALYs Gained

0.8

ICER

$250,000/QALY

Cost per Remission

$2,812,500

Cost per Responder

$750,000

Treatment Outcomes
Primary Outcomes
Overall Survival (Median)8.95 months (with chemotherapy)
+43.91% (+3.93 months)
Progression-Free Survival (Median)3.71 months (with chemotherapy)
+49.6% (+1.84 months)
Overall Response Rate17.9% (with standard chemotherapy)
+126.8% (+22.7 percentage points)
Secondary Benefits
Duration of Response (Median)3.5 months (Expected with standard chemotherapy)
+80% (+2.8 months)
Time to Confirmed Deterioration in Global Health Status/QoL2.3 months (with chemotherapy)
+86.96% (+2.0 months)
Common Side Effects
Fatigue
+55%
Peripheral neuropathy
+45%
Rash/Skin reactions
+45%

Clinical Trial Phases:

Phase 3Phase 4
5
Pembrolizumab (Keytruda)
65% Effectiveness• 90% Confidence• 50% Safety• 117 trials• 5K participants
HIGH EvidenceModerate ValueDose: 200 mg IV every 3 weeks or 400 mg IV every 6 weeks
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Comparative Safety Scale(Higher is safer)

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50
DangerousModerateSafe

Time to Effect

3-6 months

Duration

Up to 2 years or until progression

Response Rate

25%

Remission Rate

7%

Number Needed to Treat (NNT)

6

Number Needed to Harm (NNH)

8

Common Side Effects:

Fatigue: 25%
Pruritus (itching), rash: 20%
Diarrhea/Colitis: 12%
Hypothyroidism: 7%
Pneumonitis, hepatitis, nephritis (severe irAEs): 3%

Annual Cost of Care

Drug Cost

$130,000

Monitoring

$7,500

Side Effects

$10,000

Total Annual

$147,500

Cost-Effectiveness

MODERATE

QALYs Gained

1.5

ICER

$130,000/QALY

Cost per Remission

$2,107,142.86

Cost per Responder

$590,000

Treatment Outcomes
Primary Outcomes
Tumor Size Reduction (RECIST v1.1 Sum of Longest Diameters, in Responders)Average baseline sum of diameters in responders: 75 mm
-55% (-41.25 mm)
Global Health Status / Quality of Life (EORTC QLQ-C30 GHS/QoL Scale)55/100 (higher score is better)
+9% (+5 points)
Pain Severity (EORTC QLQ-C30 Pain Scale)40/100 (higher score is worse)
-20% (-8 points)
Fatigue (EORTC QLQ-C30 Fatigue Scale)50/100 (higher score is worse)
-15% (-7.5 points)
Secondary Benefits
Physical Functioning (EORTC QLQ-C30 Physical Functioning Scale)65/100 (higher score is better)
+6% (+3.9 points)
Emotional Functioning (EORTC QLQ-C30 Emotional Functioning Scale)70/100 (higher score is better)
+5% (+3.5 points)
Urinary Symptoms (EORTC QLQ-BLM30 Urinary Symptoms Scale)40/100 (higher score is worse)
-10% (-4 points)
Common Side Effects
Fatigue
+25%
Pruritus (itching), rash
+20%
Diarrhea/Colitis
+12%

Clinical Trial Phases:

Phase 3Phase 4
6
Radiation Therapy (External Beam Radiation Therapy - EBRT)
65% Effectiveness• 90% Confidence• 30% Safety• 19 trials• 15K participants
HIGH EvidenceExcellent ValueDose: 60-66 Gy in 30-33 fractions
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
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Water💧
30
DangerousModerateSafe

Time to Effect

3-6 months

Duration

6-7 weeks

Response Rate

75%

Remission Rate

45%

Number Needed to Treat (NNT)

8

Number Needed to Harm (NNH)

15

Common Side Effects:

Acute radiation cystitis: 65%
Acute radiation proctitis: 40%
Skin irritation/dermatitis: 70%
Fatigue: 60%
Chronic bladder/bowel dysfunction: 15%

Annual Cost of Care

Drug Cost

$40,000

Monitoring

$7,500

Side Effects

$5,000

Total Annual

$52,500

Cost-Effectiveness

EXCELLENT

QALYs Gained

2.5

ICER

$40,000/QALY

Cost per Remission

$116,666.67

Cost per Responder

$70,000

Treatment Outcomes
Primary Outcomes
Proportion of Patients With Pathological Response26 Participants
-92% (-24.0 Participants)
Secondary Benefits
Rate of Patients With Bladder Preserved
0%
Rate of Immediate Salvage Cystectomies1 Participants
+3000% (+30.0 Participants)
Rate of Late Salvage Cystectomies2 Participants
+1400% (+28.0 Participants)
Common Side Effects
Acute radiation cystitis
+65%
Acute radiation proctitis
+40%
Skin irritation/dermatitis
+70%

Clinical Trial Phases:

Phase 4