Top Line: Over a short period of time in, we’ve seen a lot of exciting breakthroughs in the management of muscle-invasive blade cancer (MIBC).
The Study: This International Bladder Cancer Group expert consensus statement is here to help synthesize it for us. As we all know, perioperative enfortumab vedotin/pembrolizumab has changed the conversation, with KEYNOTE-905 reporting blockbuster event-free (HR 0.40) and overall (HR 0.50) survival gains versus surgery alone and KEYNOTE-B15 reporting similar event-free (HR 0.53) and overall (HR 0.65) survival gains versus the longtime standard of neoadjuvant gem/cis. Meanwhile, contemporary retrospective comparisons suggest similar oncologic efficacy for radical cystectomy versus trimodality therapy in appropriately selected patients—reinforcing that bladder preservation is a legitimate Plan A. The panel also emphasizes multidisciplinary patient evaluation and the emerging role of circulating tumor DNA in surveillance and potential treatment escalation pathways.
TBL: The option for bladder preservation belongs in the conversation for most patients with MIBC amidst exciting rapid advancements in harnessing best outcomes with enfortumab vedotin/pembrolizumab. | Gupta, Eur Urol 2026
The Study: This International Bladder Cancer Group expert consensus statement is here to help synthesize it for us. As we all know, perioperative enfortumab vedotin/pembrolizumab has changed the conversation, with KEYNOTE-905 reporting blockbuster event-free (HR 0.40) and overall (HR 0.50) survival gains versus surgery alone and KEYNOTE-B15 reporting similar event-free (HR 0.53) and overall (HR 0.65) survival gains versus the longtime standard of neoadjuvant gem/cis. Meanwhile, contemporary retrospective comparisons suggest similar oncologic efficacy for radical cystectomy versus trimodality therapy in appropriately selected patients—reinforcing that bladder preservation is a legitimate Plan A. The panel also emphasizes multidisciplinary patient evaluation and the emerging role of circulating tumor DNA in surveillance and potential treatment escalation pathways.
TBL: The option for bladder preservation belongs in the conversation for most patients with MIBC amidst exciting rapid advancements in harnessing best outcomes with enfortumab vedotin/pembrolizumab. | Gupta, Eur Urol 2026