The test developed by Stanford researchers and the VA Palo Alto Health Care System has shown potential to diagnose bladder cancer more accurately than current standard tests, while also helping doctors predict which patients are likely to benefit from immunotherapy or chemotherapy. The findings were published in ‘Nature Medicine’ on October 2, 2026.
Cancer Research: A new urine test developed by Stanford Medicine researchers can make bladder cancer diagnosis less invasive and help doctors choose more effective treatments, according to a study.
Unlike most liquid biopsies, which look for cancer-related DNA mutations, RNA analysis reveals which genes cancer cells are actively using, offering clues not only to the presence of cancer but also to its behaviour. The test also distinguished low-grade from high-grade bladder cancer and detected residual disease after surgery and after BCG immunotherapy, a treatment in which a weakened tuberculosis vaccine bacterium is placed directly into the bladder to stimulate an immune attack on remaining cancer cells. The study included researchers from Resero Bio, a Stanford spinout formed to commercialise the technology, and the VA Palo Alto Health Care System.
In a study of 683 urine samples from patients and healthy volunteers, uRARE-seq correctly identified 95 per cent of people with localised bladder cancer and correctly gave a negative result to 90 per cent of those without the disease.
The test, called uRARE-seq, measures RNA fragments shed by tumour cells into urine, according to the research. The researchers said it performed better than standard urine cytology and a DNA-based urine test. “There are currently no biomarkers at all that are recommended or approved for surveillance,” said senior author Dr Joseph Liao, chair of urology at Stanford. “If we can guide those choices, we have the potential to help both patients and clinicians,” he stated. Several authors have ownership interests in Resero Bio or patents related to urine cell-free RNA analysis, according to the university’s disclosure.
A validated urine-based test can reduce the burden of repeated invasive procedures, enable earlier detection of recurrence, and support more personalised treatment decisions.
