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...