Indeed, matrix stiffness has been observed before the onset and invasion of the tumor in rat bladders51and higher collagen deposition and stiffness correlates with high grade in BLCA.52,53 Of note, matrix stiffness induces BLCA cell proliferation and epithelial-to-mesenchymal transition, which has been attributed to CAFs in an 3D in vitro model.54 Although further functional characterization needs to be done, our study and current literature indicate that myoCAFs promotes BLCA progression via modulation of the ECM. Here, TBX1 is linked to bladder transitional cell carcinoma.