In light of recent updates on neoadjuvant enfortumab vedotin plus pembrolizumab for muscle-invasive bladder cancer showing benefit, how should a trimodality bladder-preservation strategy be contextualized?

The treatment of muscle-invasive bladder cancer. has evolved quickly. Neoadjuvant EVP is absolutely the standard of care in all patients who can receive it. The clinical trials (EV-303/304) used cystectomy as the bladder-directed therapy, and this is the standard of care. Having said that, many pati...

Perioperative EV–pembrolizumab + radical cystectomy is now the most effective cystectomy-based strategy irrespective of cisplatin eligibility, whereas bladder preservation with a trimodality (TMT) approach offers retention of the native bladder at the cost of the validated EV–pembrolizumab benefit. ...

What are most doing these days in patients receiving Padcev with Keytruda prior to planned radical cystectomy who then end up refusing surgery and whose cystoscopy is otherwise negative for malignancy? Consolidate with XRT? Surveillance?

Interesting read:

AUA 2026: Consolidative Local Therapy After ...