Therapeutic applications of immunomodulatory nanomaterials in bladder cancer

Bladder cancer (BC) exhibits limited responsiveness to conventional therapies such as intravesical immunotherapy and chemotherapy, alongside high recurrence rates and significant treatment costs. Recent advances in immunomodulatory nanomaterials offer promising solutions by enabling precise intravesical drug delivery, prolonged urothelial retention, and targeted modulation of the tumor immune microenvironment. Various nanoplatforms including liposomes, polymers, mesoporous materials and engineered bacteria have been developed to facilitate the co-delivery of chemotherapeutic agents and immunomodulators, induce immunogenic cell death (ICD), and enhance antigen presentation. Synergistic therapeutic strategies that integrate photodynamic, sonodynamic, photothermal and magnetic hyperthermia treatments, as well as novel regulated cell death pathways such as ferroptosis, cuproptosis and disulfidptosis, have demonstrated potential in overcoming immune resistance and eliciting robust antitumor immunity. Nevertheless, several key challenges remain, including biosafety concerns, limited tumor tissue penetration, inconsistencies in large scale production, and incomplete understanding of the interactions between nanomaterials and the immune system. Future progress will rely on the integration of artificial intelligence driven nanocarrier design, multi-omics-based immune profiling, organoid-based validation models, and intelligent manufacturing technologies. These innovations are expected to accelerate the clinical translation of safe, controllable, and personalized nanomedicine-based immunotherapies, ultimately driving a paradigm shift in the precision treatment of bladder cancer.