High economic burden of immunotherapy underlines the need of predictive biomarkers for the individual therapy algorithm in metastatic bladder cancer

Bladder cancer is a highly immunogenic and heterogeneous tumor (1). Its responsiveness to immunotherapy is well known since the successful introduction of intravesical BCG in 1976 (2). This procedure still is the standard adjuvant treatment for high-risk non-muscle-invasive bladder cancer (3).