Preclinical validation in urothelial carcinoma models demonstrated that triple-combination therapy (VTP + OX40 agonist + PD-1 inhibitor) significantly improved survival outcomes, achieving 60% survival at 60 days—markedly superior to monotherapy (VTP alone: 25%), dual therapies (VTP + PD-1 inhibitor: 31.25%; VTP + OX40 agonist: 20%), and untreated controls (p<0.001). This evidence concerns the gene PDCD1 and urothelial carcinoma.