Background 

Right now, most bladder cancer treatments follow a “one-size-fits-all” plan. Doctors usually use standard treatment steps without fully considering the unique features of each patient’s cancer or how the cancer changes over time. Because of this, many patients eventually develop resistance to drugs, meaning the treatment stops working and the cancer grows again. This leads to poor outcomes for many people with bladder cancer. 

What the Study Proposes to Address 

To solve this problem, researchers are creating something called “Bio-digital Avatars.” These are highly advanced computer models that act as a virtual version of each patient’s cancer. The avatars use mathematical formulas and computer simulations to understand how the cancer behaves and changes during treatment. The models are based on information from lab-grown mini-tumors (called organoids), detailed studies of cancer cells, and artificial intelligence systems that can learn from data. 

The team has developed a deep learning system that studies serial ctDNA from cancer cells found in a patient’s blood over time. This helps the model predict how the cancer will react to different treatments and which treatment plan might work best. By simulating the cancer’s growth and responses to various therapies, the avatars can guide doctors in choosing the most effective treatment sequence for each person. 

Why This Research is Important 

This research could transform how bladder cancer is treated by moving from a general approach to one that is completely personalized. Instead of guessing which treatment might work, doctors could use each patient’s “Bio-digital Avatar” to test different options virtually before trying them in real life. This could prevent drug resistance, reduce side effects, and improve survival rates. By using cutting-edge technology to understand and predict how cancer behaves, this work represents a major step forward in providing smarter, more effective care for people with bladder cancer. 

None Reported as of August 2025

None Reported as of August 2025

Jaehee Kim, PhD; Cornell University

Background

The most common type of bladder cancer is called urothelial carcinoma. It is especially common in veterans, ranking as the fourth most common cancer they face. Every year in the United States, about 84,000 people are told they have this cancer, and about 18,000 die from it. Once this cancer spreads to other parts of the body, it becomes very difficult to cure.

Researchers recently discovered that when cancer spreads, tumors in different parts of the body are genetically not the same. They already start to look different at the genetic level very early, even at the time of diagnosis. Scientists also found that these tumors continue to change over time due to certain enzymes in the body called APOBEC3, which introduce “genetic typos.” These changes may help the cancer keep growing and spreading. But we still do not fully understand how these genetic changes help the cancer spread, and that knowledge is needed to make better treatments.

What the Study Proposes to Address

This project continues important work that was suddenly paused due to a government delay affecting research at the institution. With BCAN’s support, the team can now continue studying how APOBEC3-related genetic changes help bladder cancer cells grow, spread, and resist treatment.

During this phase, the researchers will carefully review and interpret their existing data. They will focus on finding the most promising biological signals, meaning the parts of the cancer’s behavior that might be stopped or changed with future treatments. They want to pinpoint which patterns in these genetic changes could someday help doctors choose better, more targeted therapies for patients.

Why This Research Is Important

Understanding how bladder cancer changes and evolves is key to stopping it from spreading. This work may help explain why some tumors become more aggressive and why they stop responding to treatment. By identifying the signals that drive this behavior, researchers can begin designing better therapies and more personalized medical approaches. In the long term, insights from this work could guide the development of strategies to slow or prevent bladder cancer progression, ultimately improving patient outcomes. This project also directly aligns with BCAN’s mission to improve the lives of people affected by bladder cancer, especially veterans, who are at higher risk. Because the research was interrupted by outside administrative issues, the BCAN Continuity Grant helps keep the progress moving forward. This means discoveries can continue to grow into real benefits for patients and families facing advanced bladder cancer.