Mini- Review: Current bladder cancer treatment – The need for improvement.

Bladder cancer is the tenth most common cancer and is a significant burden on health care ser-vices worldwide as it is one of the most costly cancers to treat per patient. This expense is down to the extensive treatment and follow ups that occur with costly and invasive procedures. Im-provement of both treatment options and the quality of life these interventions offer has not progressed at the rates of other cancers, and new alternatives are desperately needed to ease the burden. A more modern approach needs to be taken, with urinary biomarkers a positive step in making treatments more patient friendly, but there is still a long way to go to make these widely available and of a comparable standard to current treatment options. New targets to hit the major signalling pathways that are upregulated in bladder cancer, such as the PI3K/AkT/mTOR path-way are urgently needed, with only one drug approved so far, Erdafitinib. Immune checkpoint inhibitors also hold promise, with both PD-1 and CDLA-4 antibody therapies approved for use. They effectively block the ligand/receptor binding to block the immune checkpoint used by tu-mour cells. Other avenues must be explored, including drug repurposing and novel biomarkers which have revolutionised this area in other cancers.