To map the mechanistic landscape, historical development, and translational progress of Living Cancer Therapeutics (LCTs) in urinary bladder cancer (UBC).
Approach:
Key Findings:
LCTs, including bacteria, viruses, and microbiome-based oncobiotics, offer innovative strategies for UBC treatment.
Clinical translation has progressed for immune-mediated approaches like Bacillus Calmette–Guérin (BCG) and selected oncolytic viral platforms.
Most investigational platforms remain at early preclinical or translational stages.
Interpretation:
Despite promising early findings, significant limitations exist, including biological delivery barriers, host immune neutralization, and regulatory complexities.
Limitations:
Current evidence is limited by small studies and heterogeneous endpoints.
Challenges include delivery efficiency, therapeutic durability, and the scarcity of late-phase randomized clinical data.
Conclusion:
Further translational research, biomarker development, and long-term clinical evaluation are necessary to determine the future role of LCTs in UBC management.
