Abstract RNA splicing dysregulation is a hallmark of cancer, occurring in multiple solid and hematological malignancies. Splicing factor 3 subunit B1 (SF3B1), a key component of the U2 small nuclear ribonucleoprotein (snRNP) complex that regulates RNA splicing, is frequently altered in a variety of cancer types, including non-muscle-invasive and muscle-invasive bladder cancer, where the E902K mutation is common. In this study, we investigated the therapeutic potential of the SF3B1 inhibitor, pladienolide B, in bladder cancer using in vitro models. We used a recombinant plasmid containing the SF3B1E902K mutation and established an UMUC3E902K mutant urothelial cell line. Both UMUC3WT and UMUC3E902K cells were treated with pladienolide B alone or in combination with cisplatin to evaluate differences in cell viability. Flow cytometry using annexin V staining and propidium iodide exclusion was utilized to assess the cell death mechanism. RNAseq was performed after RNA extraction from UMUC3WT, UMUC3E902K, RT4, and HT1376 bladder cancer cell lines were treated with pladienolide alone or combined with cisplatin. We determined that the IC50 for pladienolide B is 5nM for UMUC3 cells observed 72 hours post-treatment. Treatment with pladienolide B halted the cell cycle and caused cell death by apoptosis for both UMUC3WT and UMUC3E902K cell lines. We also observed that UMUC3E902K cells were significantly more sensitive to pladienolide B compared to UMUC3WT cells (p≤0.05). Furthermore, there was a synergistic effect observed after co-treatment with low-dose pladienolide B (2 nM) and cisplatin (3 µM) for both UMUC3WT and UMUC3E902K cell lines, with UMUC3E902K cells showing greater sensitivity to combination treatment. Our results provide insights into the potential use of splicing inhibitors, alone or in combination with chemotherapy, for treating bladder cancer, specifically for tumors that bear driver mutations in splicing factors. Currently, we are evaluating the mechanism by which SF3B1 mutations make cells sensitive to pladienolide B in vitro and in vivo, with the goal of identifying specific mRNA splicing vulnerabilities that can be targeted by anti-sense or splice-switching oligonucleotides to achieve anti-tumor outcomes. Additional differential splicing patterns and preliminary in vivo results will be presented. Citation Format: Rod Carlo Columbres, Arup Chakraborty, Andrea Apolo, Rouf Banday. Unlocking the therapeutic potential of SF3B1 inhibitors for bladder cancer treatment [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 5640.