For locally advanced bladder patients who achieve a complete clinical response to neoadjuvant EV + pembrolizumab but subsequently decline cystectomy, how do you approach the decision between active surveillance and consolidative chemoradiation?

The concept of bladder-sparing therapy for management of muscle-invasive bladder cancer has been increasingly viewed favorably by both patients and physicians over the last decade. Traditional bladder-sparing approaches have been termed tri-modality therapy (TMT) and incorporated aggressive cystosco...