PURPOSE: To understand the effect of prehabilitation interventions on ≥30 days post‐treatment outcomes including physical functioning, clinical, and patient-reported outcomes in people affected by bladder cancer. METHODS: This systematic review included all randomized, quasi‐randomized, or single-arm studies in patients affected by bladder cancer (irrespective of stage or treatment modality) that compared prehabilitation intervention(s) with standard care. A range of key terms related to bladder cancer and prehabilitation were developed to search the four electronic databases. Articles were assessed according to predetermined inclusion and exclusion criteria. A methodological quality assessment was performed. RESULTS: Of the 932 studies identified, 14 studies were included and represented 1,034 participants. The interventions included multimodality prehabilitation (n = 5), exercise-only programs (n = 3), nutrition-focused interventions (n = 2), educational support (n = 3), and smoking/alcohol cessation counseling (n = 1). All of the studies were conducted in patients treated by surgery, therefore clinical and research gaps exist in the prehabilitation interventions among patients treated by intravesical therapy (ie, BCG) or radiotherapy. The key findings highlighted that multimodal program mainly showed improvements in physical function outcomes. Exercise-only interventions demonstrated some benefits in physical function. Nutrition-only interventions did not show any statistically significant improvements. Education programs showed improvements in patient-reported outcomes. Smoking and alcohol cessation counseling achieved notable abstinence rates, which were associated with fewer postoperative complications. CONCLUSION: This review suggests that prehabilitation interventions may benefit patients with bladder cancer, particularly exercise and education programs, which showed improvements in physical function and patient-reported outcomes. However, the evidence remains inconclusive, with no clear impact on clinical outcomes such as complications or hospital stay. More robust studies are needed to determine the most effective prehabilitation strategies for patients with bladder cancer.

Background/Objectives: Early-phase clinical trials (EPCTs) focus on safety and preliminary efficacy, often assessed by RECIST (Response Evaluation Criteria in Solid Tumours) tumour response. Health-related quality of life (HRQoL) is rarely evaluated in EPCTs and may not align with radiological outcomes. Methods: The PEARLER (Patient Experience in Early-Phase Cancer Clinical Trials) study evaluated the demographics, tumour response, HRQoL, and therapy type in two early-phase trial units in Australia between August 2023 and 2024. Patients completed the EORTC QLQ-C30 at baseline and follow-ups. The Global Health Status (GHS) score was selected as the primary HRQoL measure. Tumour response was assessed using RECIST 1.1. Spearman correlation and Kruskal–Wallis testing assessed the associations between RECIST, cross-sectional GHS change (ΔGHS; follow-up minus baseline), and therapy types. Multilevel models were used to evaluate longitudinal GHS values per RECIST category. Results: Of 122 patients recruited to the PEARLER study, 74 patients had paired RECIST and HRQoL data (complete response (CR) n = 0; partial response (PR) n = 15; stable disease (SD) n = 39; progressive disease (PD) n = 20). The median change in GHS was zero across RECIST groups, with broad individual variability. Notably, 18 of 54 patients (33.3%) with stable or responding disease experienced HRQoL decline. Meanwhile, 10 of 20 (50%) patients with PD experienced stable or improving HRQoL. The best RECIST response and ΔGHS showed a weak but statistically significant negative relationship (Spearman ρ = −0.28, p = 0.017), with the Kruskal–Wallis test demonstrating χ² = 6.20 (p = 0.045), indicating modest group differences driven by the deterioration in PD patients. The multilevel model demonstrated a lower GHS in patients with PD, with no statistically significant interaction of GHS change over time with the RECIST response (p = 0.226). Conclusions: HRQoL change is largely independent of radiologic tumour response and therapy type in EPCT participants. Patients experienced a HRQoL decline despite tumour response. Incorporating patient-reported outcomes alongside RECIST and safety outcomes is important to fully capture the impact of investigational therapies and guide patient-centred trial designs.