The response of the MYCN, PKIB and p-HSP27 proteins to gemcitabine found in our study implies that the inhibitory effect of gemcitabine on BLCA may be mediated through the MYCN-PKIB-PKA-HSP27 axis, which may provide new implications for the clinical treatment of BLCA. Here, HSPB1 is linked to bladder transitional cell carcinoma.