{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T11:18:58Z","timestamp":1778757538974,"version":"3.51.4"},"reference-count":64,"publisher":"Harborside Press, LLC","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:p>Radical cystectomy has long been the standard of care for muscle-invasive bladder cancer (MIBC), an aggressive cancer with a high risk of progression to recurrent or metastatic disease. Systemic therapy has improved survival outcomes for these patients, with administration in neoadjuvant, adjuvant, and, more recently, \u201csandwich\u201d perioperative settings. Cisplatin-based therapies have been the mainstay of neoadjuvant treatment for patients without comorbidities who are considered eligible for this chemotherapy. Immune checkpoint inhibition has more recently shown promise not only in prospective single-arm neoadjuvant clinical trials, but also in demonstrating significant improvement in disease-free survival when administered adjuvantly in patients at high risk of recurrence based on residual disease at the time of cystectomy. Furthermore, a biomarker-adapted approach in which patients with detectable postoperative circulating tumor DNA (ctDNA) are selected appears to enhance identification of those most likely to benefit from adjuvant immune checkpoint inhibition. Alternatively, a novel paradigm adopting a combination of preoperative and postoperative therapy sandwiched around cystectomy has been adopted in contemporary clinical trials. Two of these perioperative regimens\u2014cisplatin\/gemcitabine\/durvalumab and enfortumab vedotin\/pembrolizumab\u2014have yielded significant improvements in survival for patients with MIBC and appear poised to become the dominant systemic therapy paradigm for those with MIBC undergoing radical cystectomy. With these advances, opportunities remain to further improve patient outcomes and potentially synthesize these response-adaptive and perioperative approaches. Future studies will address the contribution of postoperative therapy and may ultimately identify patients for whom cystectomy can be deferred altogether.<\/jats:p>","DOI":"10.6004\/jnccn.2026.7034","type":"journal-article","created":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T10:32:25Z","timestamp":1778754745000},"source":"Crossref","is-referenced-by-count":0,"title":["Perioperative Systemic Treatment Options for Muscle-Invasive Bladder Cancer"],"prefix":"10.6004","volume":"24","author":[{"given":"Jason R.","family":"Brown","sequence":"first","affiliation":[{"name":"University Hospitals Seidman Cancer Center, Cleveland, OH"},{"name":"Case Western Reserve University, Cleveland, OH"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mamta","family":"Parikh","sequence":"additional","affiliation":[{"name":"UC Davis Comprehensive Cancer Center, Sacramento, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"4047","reference":[{"key":"B1","series-title":"J Urol","first-page":"805","article-title":"Treatment of advanced bladder cancer with combined preoperative irradiation and radical cystectomy versus radical cystectomy alone: a phase III intergroup study","volume":"157","author":"Smith JA","year":"1997","unstructured":"Smith JA, Crawford ED, Paradelo JC,  Treatment of advanced bladder cancer with combined preoperative irradiation and radical cystectomy versus radical cystectomy alone: a phase III intergroup study. J Urol 1997;157:805\u2013808."},{"key":"B2","series-title":"N Engl J Med","first-page":"859","article-title":"Neoadjuvant chemotherapy plus cystectomy compared with cystectomy alone for locally advanced bladder cancer","volume":"349","author":"Grossman HB","year":"2003","unstructured":"Grossman HB, Natale RB, Tangen CM,  Neoadjuvant chemotherapy plus cystectomy compared with cystectomy alone for locally advanced bladder cancer. N Engl J Med 2003;349:859\u2013866."},{"key":"B3","series-title":"J Clin Oncol","first-page":"2781","article-title":"Surgical factors influence bladder cancer outcomes: a cooperative group report","volume":"22","author":"Herr HW","year":"2004","unstructured":"Herr HW, Faulkner JR, Grossman HB,  Surgical factors influence bladder cancer outcomes: a cooperative group report. J Clin Oncol 2004;22:2781\u20132789."},{"key":"B4","series-title":"Cancer","first-page":"4104","article-title":"Quality of pathologic response and surgery correlate with survival for patients with completely resected bladder cancer after neoadjuvant chemotherapy","volume":"115","author":"Sonpavde G","year":"2009","unstructured":"Sonpavde G, Goldman BH, Speights VO,  Quality of pathologic response and surgery correlate with survival for patients with completely resected bladder cancer after neoadjuvant chemotherapy. Cancer 2009;115:4104\u20134109."},{"key":"B5","series-title":"J Clin Oncol","first-page":"1882","article-title":"Neoadjuvant dose-dense methotrexate, vinblastine, doxorubicin and cisplatin with pegfilgrastim support in muscle invasive urothelial cancer: pathologic, radiologic and biomarker correlates","volume":"32","author":"Choueiri TK","year":"2014","unstructured":"Choueiri TK, Jacobus S, Bellmunt J,  Neoadjuvant dose-dense methotrexate, vinblastine, doxorubicin and cisplatin with pegfilgrastim support in muscle invasive urothelial cancer: pathologic, radiologic and biomarker correlates. J Clin Oncol 2014;32:1882\u20131894."},{"key":"B6","series-title":"J Clin Oncol","first-page":"1895","article-title":"Accelerated methotrexate, vinblastine, doxorubicin and cisplatin is safe, effective and efficient neoadjuvant treatment for muscle invasive bladder cancer. Results of a multicenter phase II study with molecular correlates of response and toxicity","volume":"32","author":"Plimack ER","year":"2014","unstructured":"Plimack ER, Hoffman-Censits JH, Viterbo R,  Accelerated methotrexate, vinblastine, doxorubicin and cisplatin is safe, effective and efficient neoadjuvant treatment for muscle invasive bladder cancer. Results of a multicenter phase II study with molecular correlates of response and toxicity. J Clin Oncol 2014;32:1895\u20131901."},{"key":"B7","series-title":"Cancer","first-page":"2471","article-title":"A role for neoadjuvant gemcitabine plus cisplatin in muscle-invasive urothelial carcinoma of the bladder: a retrospective experience","volume":"113","author":"Dash A","year":"2008","unstructured":"Dash A, Pettus JA, Herr HW,  A role for neoadjuvant gemcitabine plus cisplatin in muscle-invasive urothelial carcinoma of the bladder: a retrospective experience. Cancer 2008;113:2471\u20132477."},{"key":"B8","series-title":"Clin Cancer Res","first-page":"2435","article-title":"A randomized phase II study of coexpression extrapolation (COXEN) with neoadjuvant chemotherapy for bladder cancer (SWOG S1314; NCT02177695)","volume":"27","author":"Flaig TW","year":"2021","unstructured":"Flaig TW, Tangen CM, Daneshmand S,  A randomized phase II study of coexpression extrapolation (COXEN) with neoadjuvant chemotherapy for bladder cancer (SWOG S1314; NCT02177695). Clin Cancer Res 2021;27:2435\u20132441."},{"key":"B9","series-title":"J Clin Oncol","first-page":"2013","article-title":"Dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin or gemcitabine and cisplatin as perioperative chemotherapy for patients with nonmetastatic muscle-invasive bladder cancer: results of the GETUG-AFU V05 VESPER trial","volume":"40","author":"Pfister C","year":"2022","unstructured":"Pfister C, Gravis G, Fl\u00e9chon A,  Dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin or gemcitabine and cisplatin as perioperative chemotherapy for patients with nonmetastatic muscle-invasive bladder cancer: results of the GETUG-AFU V05 VESPER trial. J Clin Oncol 2022;40:2013\u20132022."},{"key":"B10","series-title":"Lancet Oncol","first-page":"255","article-title":"Perioperative dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin in muscle-invasive bladder cancer (VESPER): survival endpoints at 5 years in an open-label, randomised, phase 3 study","volume":"25","author":"Pfister C","year":"2024","unstructured":"Pfister C, Gravis G, Flechon A,  Perioperative dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin in muscle-invasive bladder cancer (VESPER): survival endpoints at 5 years in an open-label, randomised, phase 3 study. Lancet Oncol 2024;25:255\u2013264."},{"key":"B11","series-title":"Lancet Oncol","first-page":"211","article-title":"A consensus definition of patients with metastatic urothelial carcinoma who are unfit for cisplatin-based chemotherapy","volume":"12","author":"Galsky MD","year":"2011","unstructured":"Galsky MD, Hahn NM, Rosenberg J,  A consensus definition of patients with metastatic urothelial carcinoma who are unfit for cisplatin-based chemotherapy. Lancet Oncol 2011;12:211\u2013214."},{"key":"B12","series-title":"J Clin Oncol","first-page":"3353","article-title":"Pembrolizumab as neoadjuvant therapy before radical cystectomy in patients with muscle-invasive urothelial bladder carcinoma (PURE-01): an open-label, single-arm, phase II study","volume":"36","author":"Necchi A","year":"2018","unstructured":"Necchi A, Anichini A, Raggi D,  Pembrolizumab as neoadjuvant therapy before radical cystectomy in patients with muscle-invasive urothelial bladder carcinoma (PURE-01): an open-label, single-arm, phase II study. J Clin Oncol 2018;36:3353\u20133360."},{"key":"B13","series-title":"Clin Cancer Res","first-page":"5107","article-title":"Neoadjuvant pembrolizumab and radical cystectomy in patients with muscle-invasive bladder cancer: 3-year median follow-up update of PURE-01 trial","volume":"28","author":"Basile G","year":"2022","unstructured":"Basile G, Bandini M, Gibb EA,  Neoadjuvant pembrolizumab and radical cystectomy in patients with muscle-invasive bladder cancer: 3-year median follow-up update of PURE-01 trial. Clin Cancer Res 2022;28:5107\u20135114."},{"key":"B14","series-title":"Eur Urol","first-page":"212","article-title":"Final results of neoadjuvant atezolizumab in cisplatin-ineligible patients with muscle-invasive urothelial cancer of the bladder","volume":"82","author":"Szabados B","year":"2022","unstructured":"Szabados B, Kockx M, Assaf ZJ,  Final results of neoadjuvant atezolizumab in cisplatin-ineligible patients with muscle-invasive urothelial cancer of the bladder. Eur Urol 2022;82:212\u2013222."},{"key":"B15","series-title":"Immunotherapy","first-page":"1407","article-title":"Neoadjuvant immunochemotherapy in the treatment of nonmetastatic muscle-invasive bladder cancer: a systematic review","volume":"14","author":"Sarkis J","year":"2022","unstructured":"Sarkis J, Vannier E, Mjaess G,  Neoadjuvant immunochemotherapy in the treatment of nonmetastatic muscle-invasive bladder cancer: a systematic review. Immunotherapy 2022;14:1407\u20131417."},{"key":"B16","series-title":"Eur Urol","first-page":"42","article-title":"Adjuvant chemotherapy for invasive bladder cancer: a 2013 updated systematic review and meta-analysis of randomized trials","volume":"66","author":"Leow JJ","year":"2014","unstructured":"Leow JJ, Martin-Doyle W, Rajagopal PS,  Adjuvant chemotherapy for invasive bladder cancer: a 2013 updated systematic review and meta-analysis of randomized trials. Eur Urol 2014;66:42\u201354."},{"key":"B17","series-title":"Eur Urol","first-page":"50","article-title":"Adjuvant chemotherapy for muscle-invasive bladder cancer: a systematic review and meta-analysis of individual participant data from randomised controlled trials","volume":"81","year":"2022","unstructured":"Advanced Bladder Cancer (ABC) Meta-Analysis Collaborators Group. Adjuvant chemotherapy for muscle-invasive bladder cancer: a systematic review and meta-analysis of individual participant data from randomised controlled trials. Eur Urol 2022;81:50\u201361."},{"key":"B18","series-title":"N Engl J Med","first-page":"2102","article-title":"Adjuvant nivolumab versus placebo in muscle-invasive urothelial carcinoma","volume":"384","author":"Bajorin DF","year":"2021","unstructured":"Bajorin DF, Witjes JA, Gschwend JE,  Adjuvant nivolumab versus placebo in muscle-invasive urothelial carcinoma. N Engl J Med 2021;384:2102\u20132114."},{"key":"B19","series-title":"Ann Oncol","first-page":"69","article-title":"Adjuvant nivolumab versus placebo for high-risk muscle-invasive urothelial carcinoma: 5-year efficacy and ctDNA results from CheckMate 274","volume":"37","author":"Galsky MD","year":"2026","unstructured":"Galsky MD, Gschwend JE, Milowsky MI,  Adjuvant nivolumab versus placebo for high-risk muscle-invasive urothelial carcinoma: 5-year efficacy and ctDNA results from CheckMate 274. Ann Oncol 2026;37:69\u201378."},{"key":"B20","series-title":"N Engl J Med","first-page":"45","article-title":"Adjuvant pembrolizumab versus observation in muscle-invasive urothelial carcinoma","volume":"392","author":"Apolo AB","year":"2025","unstructured":"Apolo AB, Ballman KV, Sonpavde G,  Adjuvant pembrolizumab versus observation in muscle-invasive urothelial carcinoma. N Engl J Med 2025;392:45\u201355."},{"key":"B21","series-title":"Lancet Oncol","first-page":"525","article-title":"Adjuvant atezolizumab versus observation in muscle-invasive urothelial carcinoma (IMvigor010): a multicentre, open-label, randomised, phase 3 trial","volume":"22","author":"Bellmunt J","year":"2021","unstructured":"Bellmunt J, Hussain M, Gschwend JE,  Adjuvant atezolizumab versus observation in muscle-invasive urothelial carcinoma (IMvigor010): a multicentre, open-label, randomised, phase 3 trial. Lancet Oncol 2021;22:525\u2013537."},{"key":"B22","series-title":"Nature","first-page":"432","article-title":"ctDNA guiding adjuvant immunotherapy in urothelial carcinoma","volume":"595","author":"Powles T","year":"2021","unstructured":"Powles T, Assaf ZJ, Davarpanah N,  ctDNA guiding adjuvant immunotherapy in urothelial carcinoma. Nature 2021;595:432\u2013437."},{"key":"B23","series-title":"N Engl J Med","first-page":"2395","article-title":"ctDNA-guided adjuvant atezolizumab in muscle-invasive bladder cancer","volume":"393","author":"Powles T","year":"2025","unstructured":"Powles T, Kann AG, Castellano D,  ctDNA-guided adjuvant atezolizumab in muscle-invasive bladder cancer. N Engl J Med 2025;393: 2395\u20132408."},{"key":"B24","series-title":"N Engl J Med","first-page":"1773","article-title":"Perioperative durvalumab with neoadjuvant chemotherapy in operable bladder cancer","volume":"391","author":"Powles T","year":"2024","unstructured":"Powles T, Catto JWF, Galsky MD,  Perioperative durvalumab with neoadjuvant chemotherapy in operable bladder cancer. N Engl J Med 2024;391:1773\u20131786."},{"key":"B25","series-title":"Future Oncol","first-page":"3137","article-title":"Perioperative pembrolizumab therapy in muscle-invasive bladder cancer: phase III KEYNOTE-866 and KEYNOTE-905\/EV-303","volume":"17","author":"Galsky MD","year":"2021","unstructured":"Galsky MD, Hoimes CJ, Necchi A,  Perioperative pembrolizumab therapy in muscle-invasive bladder cancer: phase III KEYNOTE-866 and KEYNOTE-905\/EV-303. Future Oncol 2021;17:3137\u20133150."},{"key":"B26","series-title":"Future Oncol","first-page":"4359","article-title":"ENERGIZE: a phase III study of neoadjuvant chemotherapy alone or with nivolumab wiht\/without linrodostat mesylate for muscle-invasive bladder cancer","volume":"16","author":"Sonpavde G","year":"2020","unstructured":"Sonpavde G, Necchi A, Gupta S,  ENERGIZE: a phase III study of neoadjuvant chemotherapy alone or with nivolumab wiht\/without linrodostat mesylate for muscle-invasive bladder cancer. Future Oncol 2020;16:4359\u20134368."},{"key":"B27","series-title":"N Engl J Med","first-page":"875","article-title":"Enfortumab vedotin and pembrolizumab in untreated advanced urothelial cancer","volume":"390","author":"Powles T","year":"2024","unstructured":"Powles T, Valderrama BP, Gupta S,  Enfortumab vedotin and pembrolizumab in untreated advanced urothelial cancer. N Engl J Med 2024;390:875\u2013888."},{"key":"B28","series-title":"J Clin Oncol","first-page":"4583","article-title":"Study EV-103 cohort H: neoadjuvant treatment with enfortumab vedotin (EV) monotherapy in cisplatin (cis)-ineligible patients (pts) with muscle invasive bladder cancer (MIBC)- 3-year efficacy results","volume":"43","author":"Mar N","year":"2025","unstructured":"Mar N, Petrylak DP, Hoimes CJ,  Study EV-103 cohort H: neoadjuvant treatment with enfortumab vedotin (EV) monotherapy in cisplatin (cis)-ineligible patients (pts) with muscle invasive bladder cancer (MIBC)- 3-year efficacy results. J Clin Oncol 2025;43:4583\u20134583."},{"key":"B29","series-title":"N Engl J Med.","article-title":"Perioperative enfortumab vedotin and pembrolizumab in bladder cancer","author":"Vulsteke C","unstructured":"Vulsteke C, Adra N, Danchaivijitr P,  Perioperative enfortumab vedotin and pembrolizumab in bladder cancer. N Engl J Med. Published online February 18, 2026. doi:https:\/\/doi.org\/10.1056\/NEJMoa2511674"},{"key":"B30","series-title":"Nat Med","first-page":"2825","article-title":"Gemcitabine and cisplatin plus nivolumab as organ-sparing treatment for muscle invasive bladder cancer: a phase 2 trial","volume":"29","author":"Galsky MD","year":"2023","unstructured":"Galsky MD, Daneshmand S, Izadmehr S,  Gemcitabine and cisplatin plus nivolumab as organ-sparing treatment for muscle invasive bladder cancer: a phase 2 trial. Nat Med 2023;29:2825\u20132834."},{"key":"B31","series-title":"J Clin Oncol","first-page":"1113","article-title":"Phase II trial of risk-enabled therapy after neoadjuvant chemotherapy for muscle-invasive bladder cancer (RETAIN 1)","volume":"43","author":"Geynisman DM","year":"2025","unstructured":"Geynisman DM, Abbosh PH, Ross E,  Phase II trial of risk-enabled therapy after neoadjuvant chemotherapy for muscle-invasive bladder cancer (RETAIN 1). J Clin Oncol 2025;43:1113\u20131122."},{"key":"B32","series-title":"J Clin Oncol","first-page":"815","article-title":"A phase 2 trial of risk enabled therapy after neoadjuvant chemo-immunotherapy for muscle-invasive bladder cancer (RETAIN-2)","volume":"43","author":"Ghatalia P","year":"2025","unstructured":"Ghatalia P, Ross EA, Zibelman MR,  A phase 2 trial of risk enabled therapy after neoadjuvant chemo-immunotherapy for muscle-invasive bladder cancer (RETAIN-2). J Clin Oncol 2025;43:815\u2013815."},{"key":"B1","series-title":"J Urol","first-page":"805","article-title":"Treatment of advanced bladder cancer with combined preoperative irradiation and radical cystectomy versus radical cystectomy alone: a phase III intergroup study","volume":"157","author":"Smith JA","year":"1997","unstructured":"Smith JA, Crawford ED, Paradelo JC,  Treatment of advanced bladder cancer with combined preoperative irradiation and radical cystectomy versus radical cystectomy alone: a phase III intergroup study. J Urol 1997;157:805\u2013808."},{"key":"B2","series-title":"N Engl J Med","first-page":"859","article-title":"Neoadjuvant chemotherapy plus cystectomy compared with cystectomy alone for locally advanced bladder cancer","volume":"349","author":"Grossman HB","year":"2003","unstructured":"Grossman HB, Natale RB, Tangen CM,  Neoadjuvant chemotherapy plus cystectomy compared with cystectomy alone for locally advanced bladder cancer. N Engl J Med 2003;349:859\u2013866."},{"key":"B3","series-title":"J Clin Oncol","first-page":"2781","article-title":"Surgical factors influence bladder cancer outcomes: a cooperative group report","volume":"22","author":"Herr HW","year":"2004","unstructured":"Herr HW, Faulkner JR, Grossman HB,  Surgical factors influence bladder cancer outcomes: a cooperative group report. J Clin Oncol 2004;22:2781\u20132789."},{"key":"B4","series-title":"Cancer","first-page":"4104","article-title":"Quality of pathologic response and surgery correlate with survival for patients with completely resected bladder cancer after neoadjuvant chemotherapy","volume":"115","author":"Sonpavde G","year":"2009","unstructured":"Sonpavde G, Goldman BH, Speights VO,  Quality of pathologic response and surgery correlate with survival for patients with completely resected bladder cancer after neoadjuvant chemotherapy. Cancer 2009;115:4104\u20134109."},{"key":"B5","series-title":"J Clin Oncol","first-page":"1882","article-title":"Neoadjuvant dose-dense methotrexate, vinblastine, doxorubicin and cisplatin with pegfilgrastim support in muscle invasive urothelial cancer: pathologic, radiologic and biomarker correlates","volume":"32","author":"Choueiri TK","year":"2014","unstructured":"Choueiri TK, Jacobus S, Bellmunt J,  Neoadjuvant dose-dense methotrexate, vinblastine, doxorubicin and cisplatin with pegfilgrastim support in muscle invasive urothelial cancer: pathologic, radiologic and biomarker correlates. J Clin Oncol 2014;32:1882\u20131894."},{"key":"B6","series-title":"J Clin Oncol","first-page":"1895","article-title":"Accelerated methotrexate, vinblastine, doxorubicin and cisplatin is safe, effective and efficient neoadjuvant treatment for muscle invasive bladder cancer. Results of a multicenter phase II study with molecular correlates of response and toxicity","volume":"32","author":"Plimack ER","year":"2014","unstructured":"Plimack ER, Hoffman-Censits JH, Viterbo R,  Accelerated methotrexate, vinblastine, doxorubicin and cisplatin is safe, effective and efficient neoadjuvant treatment for muscle invasive bladder cancer. Results of a multicenter phase II study with molecular correlates of response and toxicity. J Clin Oncol 2014;32:1895\u20131901."},{"key":"B7","series-title":"Cancer","first-page":"2471","article-title":"A role for neoadjuvant gemcitabine plus cisplatin in muscle-invasive urothelial carcinoma of the bladder: a retrospective experience","volume":"113","author":"Dash A","year":"2008","unstructured":"Dash A, Pettus JA, Herr HW,  A role for neoadjuvant gemcitabine plus cisplatin in muscle-invasive urothelial carcinoma of the bladder: a retrospective experience. Cancer 2008;113:2471\u20132477."},{"key":"B8","series-title":"Clin Cancer Res","first-page":"2435","article-title":"A randomized phase II study of coexpression extrapolation (COXEN) with neoadjuvant chemotherapy for bladder cancer (SWOG S1314; NCT02177695)","volume":"27","author":"Flaig TW","year":"2021","unstructured":"Flaig TW, Tangen CM, Daneshmand S,  A randomized phase II study of coexpression extrapolation (COXEN) with neoadjuvant chemotherapy for bladder cancer (SWOG S1314; NCT02177695). Clin Cancer Res 2021;27:2435\u20132441."},{"key":"B9","series-title":"J Clin Oncol","first-page":"2013","article-title":"Dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin or gemcitabine and cisplatin as perioperative chemotherapy for patients with nonmetastatic muscle-invasive bladder cancer: results of the GETUG-AFU V05 VESPER trial","volume":"40","author":"Pfister C","year":"2022","unstructured":"Pfister C, Gravis G, Fl\u00e9chon A,  Dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin or gemcitabine and cisplatin as perioperative chemotherapy for patients with nonmetastatic muscle-invasive bladder cancer: results of the GETUG-AFU V05 VESPER trial. J Clin Oncol 2022;40:2013\u20132022."},{"key":"B10","series-title":"Lancet Oncol","first-page":"255","article-title":"Perioperative dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin in muscle-invasive bladder cancer (VESPER): survival endpoints at 5 years in an open-label, randomised, phase 3 study","volume":"25","author":"Pfister C","year":"2024","unstructured":"Pfister C, Gravis G, Flechon A,  Perioperative dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin in muscle-invasive bladder cancer (VESPER): survival endpoints at 5 years in an open-label, randomised, phase 3 study. Lancet Oncol 2024;25:255\u2013264."},{"key":"B11","series-title":"Lancet Oncol","first-page":"211","article-title":"A consensus definition of patients with metastatic urothelial carcinoma who are unfit for cisplatin-based chemotherapy","volume":"12","author":"Galsky MD","year":"2011","unstructured":"Galsky MD, Hahn NM, Rosenberg J,  A consensus definition of patients with metastatic urothelial carcinoma who are unfit for cisplatin-based chemotherapy. Lancet Oncol 2011;12:211\u2013214."},{"key":"B12","series-title":"J Clin Oncol","first-page":"3353","article-title":"Pembrolizumab as neoadjuvant therapy before radical cystectomy in patients with muscle-invasive urothelial bladder carcinoma (PURE-01): an open-label, single-arm, phase II study","volume":"36","author":"Necchi A","year":"2018","unstructured":"Necchi A, Anichini A, Raggi D,  Pembrolizumab as neoadjuvant therapy before radical cystectomy in patients with muscle-invasive urothelial bladder carcinoma (PURE-01): an open-label, single-arm, phase II study. J Clin Oncol 2018;36:3353\u20133360."},{"key":"B13","series-title":"Clin Cancer Res","first-page":"5107","article-title":"Neoadjuvant pembrolizumab and radical cystectomy in patients with muscle-invasive bladder cancer: 3-year median follow-up update of PURE-01 trial","volume":"28","author":"Basile G","year":"2022","unstructured":"Basile G, Bandini M, Gibb EA,  Neoadjuvant pembrolizumab and radical cystectomy in patients with muscle-invasive bladder cancer: 3-year median follow-up update of PURE-01 trial. Clin Cancer Res 2022;28:5107\u20135114."},{"key":"B14","series-title":"Eur Urol","first-page":"212","article-title":"Final results of neoadjuvant atezolizumab in cisplatin-ineligible patients with muscle-invasive urothelial cancer of the bladder","volume":"82","author":"Szabados B","year":"2022","unstructured":"Szabados B, Kockx M, Assaf ZJ,  Final results of neoadjuvant atezolizumab in cisplatin-ineligible patients with muscle-invasive urothelial cancer of the bladder. Eur Urol 2022;82:212\u2013222."},{"key":"B15","series-title":"Immunotherapy","first-page":"1407","article-title":"Neoadjuvant immunochemotherapy in the treatment of nonmetastatic muscle-invasive bladder cancer: a systematic review","volume":"14","author":"Sarkis J","year":"2022","unstructured":"Sarkis J, Vannier E, Mjaess G,  Neoadjuvant immunochemotherapy in the treatment of nonmetastatic muscle-invasive bladder cancer: a systematic review. Immunotherapy 2022;14:1407\u20131417."},{"key":"B16","series-title":"Eur Urol","first-page":"42","article-title":"Adjuvant chemotherapy for invasive bladder cancer: a 2013 updated systematic review and meta-analysis of randomized trials","volume":"66","author":"Leow JJ","year":"2014","unstructured":"Leow JJ, Martin-Doyle W, Rajagopal PS,  Adjuvant chemotherapy for invasive bladder cancer: a 2013 updated systematic review and meta-analysis of randomized trials. Eur Urol 2014;66:42\u201354."},{"key":"B17","series-title":"Eur Urol","first-page":"50","article-title":"Adjuvant chemotherapy for muscle-invasive bladder cancer: a systematic review and meta-analysis of individual participant data from randomised controlled trials","volume":"81","year":"2022","unstructured":"Advanced Bladder Cancer (ABC) Meta-Analysis Collaborators Group. Adjuvant chemotherapy for muscle-invasive bladder cancer: a systematic review and meta-analysis of individual participant data from randomised controlled trials. Eur Urol 2022;81:50\u201361."},{"key":"B18","series-title":"N Engl J Med","first-page":"2102","article-title":"Adjuvant nivolumab versus placebo in muscle-invasive urothelial carcinoma","volume":"384","author":"Bajorin DF","year":"2021","unstructured":"Bajorin DF, Witjes JA, Gschwend JE,  Adjuvant nivolumab versus placebo in muscle-invasive urothelial carcinoma. N Engl J Med 2021;384:2102\u20132114."},{"key":"B19","series-title":"Ann Oncol","first-page":"69","article-title":"Adjuvant nivolumab versus placebo for high-risk muscle-invasive urothelial carcinoma: 5-year efficacy and ctDNA results from CheckMate 274","volume":"37","author":"Galsky MD","year":"2026","unstructured":"Galsky MD, Gschwend JE, Milowsky MI,  Adjuvant nivolumab versus placebo for high-risk muscle-invasive urothelial carcinoma: 5-year efficacy and ctDNA results from CheckMate 274. Ann Oncol 2026;37:69\u201378."},{"key":"B20","series-title":"N Engl J Med","first-page":"45","article-title":"Adjuvant pembrolizumab versus observation in muscle-invasive urothelial carcinoma","volume":"392","author":"Apolo AB","year":"2025","unstructured":"Apolo AB, Ballman KV, Sonpavde G,  Adjuvant pembrolizumab versus observation in muscle-invasive urothelial carcinoma. N Engl J Med 2025;392:45\u201355."},{"key":"B21","series-title":"Lancet Oncol","first-page":"525","article-title":"Adjuvant atezolizumab versus observation in muscle-invasive urothelial carcinoma (IMvigor010): a multicentre, open-label, randomised, phase 3 trial","volume":"22","author":"Bellmunt J","year":"2021","unstructured":"Bellmunt J, Hussain M, Gschwend JE,  Adjuvant atezolizumab versus observation in muscle-invasive urothelial carcinoma (IMvigor010): a multicentre, open-label, randomised, phase 3 trial. Lancet Oncol 2021;22:525\u2013537."},{"key":"B22","series-title":"Nature","first-page":"432","article-title":"ctDNA guiding adjuvant immunotherapy in urothelial carcinoma","volume":"595","author":"Powles T","year":"2021","unstructured":"Powles T, Assaf ZJ, Davarpanah N,  ctDNA guiding adjuvant immunotherapy in urothelial carcinoma. Nature 2021;595:432\u2013437."},{"key":"B23","series-title":"N Engl J Med","first-page":"2395","article-title":"ctDNA-guided adjuvant atezolizumab in muscle-invasive bladder cancer","volume":"393","author":"Powles T","year":"2025","unstructured":"Powles T, Kann AG, Castellano D,  ctDNA-guided adjuvant atezolizumab in muscle-invasive bladder cancer. N Engl J Med 2025;393: 2395\u20132408."},{"key":"B24","series-title":"N Engl J Med","first-page":"1773","article-title":"Perioperative durvalumab with neoadjuvant chemotherapy in operable bladder cancer","volume":"391","author":"Powles T","year":"2024","unstructured":"Powles T, Catto JWF, Galsky MD,  Perioperative durvalumab with neoadjuvant chemotherapy in operable bladder cancer. N Engl J Med 2024;391:1773\u20131786."},{"key":"B25","series-title":"Future Oncol","first-page":"3137","article-title":"Perioperative pembrolizumab therapy in muscle-invasive bladder cancer: phase III KEYNOTE-866 and KEYNOTE-905\/EV-303","volume":"17","author":"Galsky MD","year":"2021","unstructured":"Galsky MD, Hoimes CJ, Necchi A,  Perioperative pembrolizumab therapy in muscle-invasive bladder cancer: phase III KEYNOTE-866 and KEYNOTE-905\/EV-303. Future Oncol 2021;17:3137\u20133150."},{"key":"B26","series-title":"Future Oncol","first-page":"4359","article-title":"ENERGIZE: a phase III study of neoadjuvant chemotherapy alone or with nivolumab wiht\/without linrodostat mesylate for muscle-invasive bladder cancer","volume":"16","author":"Sonpavde G","year":"2020","unstructured":"Sonpavde G, Necchi A, Gupta S,  ENERGIZE: a phase III study of neoadjuvant chemotherapy alone or with nivolumab wiht\/without linrodostat mesylate for muscle-invasive bladder cancer. Future Oncol 2020;16:4359\u20134368."},{"key":"B27","series-title":"N Engl J Med","first-page":"875","article-title":"Enfortumab vedotin and pembrolizumab in untreated advanced urothelial cancer","volume":"390","author":"Powles T","year":"2024","unstructured":"Powles T, Valderrama BP, Gupta S,  Enfortumab vedotin and pembrolizumab in untreated advanced urothelial cancer. N Engl J Med 2024;390:875\u2013888."},{"key":"B28","series-title":"J Clin Oncol","first-page":"4583","article-title":"Study EV-103 cohort H: neoadjuvant treatment with enfortumab vedotin (EV) monotherapy in cisplatin (cis)-ineligible patients (pts) with muscle invasive bladder cancer (MIBC)- 3-year efficacy results","volume":"43","author":"Mar N","year":"2025","unstructured":"Mar N, Petrylak DP, Hoimes CJ,  Study EV-103 cohort H: neoadjuvant treatment with enfortumab vedotin (EV) monotherapy in cisplatin (cis)-ineligible patients (pts) with muscle invasive bladder cancer (MIBC)- 3-year efficacy results. J Clin Oncol 2025;43:4583\u20134583."},{"key":"B29","series-title":"N Engl J Med.","article-title":"Perioperative enfortumab vedotin and pembrolizumab in bladder cancer","author":"Vulsteke C","unstructured":"Vulsteke C, Adra N, Danchaivijitr P,  Perioperative enfortumab vedotin and pembrolizumab in bladder cancer. N Engl J Med. Published online February 18, 2026. doi:https:\/\/doi.org\/10.1056\/NEJMoa2511674"},{"key":"B30","series-title":"Nat Med","first-page":"2825","article-title":"Gemcitabine and cisplatin plus nivolumab as organ-sparing treatment for muscle invasive bladder cancer: a phase 2 trial","volume":"29","author":"Galsky MD","year":"2023","unstructured":"Galsky MD, Daneshmand S, Izadmehr S,  Gemcitabine and cisplatin plus nivolumab as organ-sparing treatment for muscle invasive bladder cancer: a phase 2 trial. Nat Med 2023;29:2825\u20132834."},{"key":"B31","series-title":"J Clin Oncol","first-page":"1113","article-title":"Phase II trial of risk-enabled therapy after neoadjuvant chemotherapy for muscle-invasive bladder cancer (RETAIN 1)","volume":"43","author":"Geynisman DM","year":"2025","unstructured":"Geynisman DM, Abbosh PH, Ross E,  Phase II trial of risk-enabled therapy after neoadjuvant chemotherapy for muscle-invasive bladder cancer (RETAIN 1). J Clin Oncol 2025;43:1113\u20131122."},{"key":"B32","series-title":"J Clin Oncol","first-page":"815","article-title":"A phase 2 trial of risk enabled therapy after neoadjuvant chemo-immunotherapy for muscle-invasive bladder cancer (RETAIN-2)","volume":"43","author":"Ghatalia P","year":"2025","unstructured":"Ghatalia P, Ross EA, Zibelman MR,  A phase 2 trial of risk enabled therapy after neoadjuvant chemo-immunotherapy for muscle-invasive bladder cancer (RETAIN-2). J Clin Oncol 2025;43:815\u2013815."}],"container-title":["Journal of the National Comprehensive Cancer Network"],"original-title":[],"link":[{"URL":"https:\/\/jnccn.org\/view\/journals\/jnccn\/24\/5\/article-e267034.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/jnccn.org\/downloadpdf\/journals\/jnccn\/24\/5\/article-e267034.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/jnccn.org\/downloadpdf\/journals\/jnccn\/24\/5\/article-e267034.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T10:32:25Z","timestamp":1778754745000},"score":1,"resource":{"primary":{"URL":"https:\/\/jnccn.org\/view\/journals\/jnccn\/24\/5\/article-e267034.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":64,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.6004\/jnccn.2026.7034","relation":{},"ISSN":["1540-1405","1540-1413"],"issn-type":[{"value":"1540-1405","type":"print"},{"value":"1540-1413","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5]]}}}