The future of personalized bladder cancer care 

How advances in research are bringing new hope  

May is Bladder Cancer Awareness Month, a moment to recognize the people behind every diagnosis: patients navigating difficult decisions, the friends and family offering support along the way, and healthcare professionals dedicated to delivering the best possible care.  

Alongside this shared commitment to care, ongoing advances from the research community continue to deepen our understanding of bladder cancer, improving approaches to treatment paths and bringing renewed hope for better patient outcomes.

What is bladder cancer?

Bladder cancer is one of the most common cancers worldwide¹ and is usually classified into two main categories: non-muscle-invasive bladder cancer (NMIBC), and muscle-invasive bladder cancer (MIBC).² 

Bladder cancer typically starts in the inner lining of the bladder. A tumor that remains limited to this inner lining is considered NMIBC. When it spreads into the bladder’s muscle wall, it is known as MIBC.³ 

Of the more than 84,000 people in the United States expected to be diagnosed with this disease in 2026⁴, roughly three quarters of those cases will be NMIBC.⁵

The biology of bladder cancer and what it means for care 

Bladder cancer does not behave the same way in every person. Differences in tumor biology can influence how the disease behaves, its aggressiveness, how likely it is to progress, and how it is treated. 

As a result, treatment plans must account for this variability. Traditional clinicopathologic tools such as staging and pathology show how far the cancer has invaded adjacent layers of tissue, including the muscle lining, but they do not always show how aggressive it may be. 

During such uncertainty, clear and meaningful answers can also play an important role for clinicians and the patients they serve. Fortunately, advancements in research offer deeper biological insight into a patient’s bladder tumor and can help guide more personalized treatment decisions. 

This is the focus of the Decipher Bladder Genomic Classifier.

Revealing underlying biological insights with Decipher Bladder

Decipher Bladder is a molecular subtyping test that can help identify patients with tumors more likely to spread beyond the bladder, experience disease progression, and who may also benefit more from additional therapy. The test analyzes 219 genes and groups a patient’s tumor into one of the two main categories: Luminal or Non-Luminal. This information may help inform:

• Whether the cancer may be more aggressive than expected.  
• The probability that the cancer may progress.  
• Which treatments may be most appropriate. 
  

The test is intended for patients with clinical stage T1 to T4a bladder cancer and is covered by Medicare. 

Helping advance bladder cancer science through evidence, innovation, and collaboration

Decipher Bladder is supported by a growing body of evidence, including more than 15 analyses in prospective trials and more than 19 peer-reviewed publications.⁶ Together, this research highlights not only the clinical validity and utility of the test, but also the role of molecular subtyping in improving how bladder cancer risk is understood and how care may be guided.

Recent studies have helped illustrate this evolving picture.^7,8 For example, a study published in European Urology Open Science  in 2025 suggested that in patients with clinical T1 (cT1) NMIBC (an early stage in which cancer has grown into the connective tissue beneath the bladder lining but not deeper into the muscle layer), tumors classified as Luminal subtypes are less likely to progress, remain confined to the bladder, and are associated with improved overall outcomes as compared to Non-Luminal subtype tumors.⁸

Separately, an analysis of Decipher Bladder in 259 high-risk NMIBC patients was presented at the 2026 ASCO Genitourinary (GU) Cancers Symposium. This study reinforced the above finding in high-risk cT1 NMIBC patients that Luminal subtypes have less aggressive biology than Non-Luminal subtypes. This information may help provide additional context when considering management strategies and counseling around disease risk. Abstract presenter and first author Joep de Jong, M.D., Ph.D. (Urology Consultant, Veracyte; Coordinating Investigator, Erasmus University Medical Center) spoke with UroToday about the findings and their implications for the field. You can watch the full discussion here.

Beyond individual studies, Veracyte continues to progress scientific discovery through the Decipher GRID (Genomic Resource for Intelligent Discovery), a proprietary, research-use-only database designed to advance understanding of urologic cancers at the molecular level. By enabling researchers and clinicians to explore gene-expression data at scale, the Decipher GRID supports deeper insights into bladder cancer biology and disease progression. It is considered the largest and most well-annotated urologic oncology gene-expression database in the world.⁶

This continued commitment to research is reflected in Veracyte’s collaboration with the urologic oncology community. At this month’s American Urological Association (AUA) Annual Meeting, Veracyte and esteemed collaborators will present several studies demonstrating how Decipher Bladder is being used to help refine risk stratification, identify patient subsets with differing clinical outcomes, and deepen understanding of tumor biology.

Read our press release to learn more.

Transforming uncertainty into clarity in the cancer care journey

At Veracyte, our commitment to bladder cancer research and innovation is unwavering. We continue to invest in landmark clinical studies and collaborate alongside leading scientists and clinicians to further validate how our cancer tests can help guide critical decisions across the cancer care continuum. 

As your ally in the race against cancer, we believe the stronger we are together, the more we weaken cancer.  

To learn more, explore curated resources for patients and providers, or connect with a member of our team.