Emerging Combination Perioperative Strategies in MIBC

In “Emerging Combination Perioperative Strategies in MIBC,” our panel explores how emerging clinical trials may further refine perioperative treatment approaches for muscle-invasive bladder cancer (MIBC). The expert faculty discuss ongoing studies including KEYNOTE-866, ENERGIZE, and VOLGA, and examine how newer combinations of immunotherapy, chemotherapy, and antibody-drug conjugates may continue to reshape the perioperative treatment landscape.

Throughout the discussion, the panelists review the biological rationale behind intensifying perioperative therapy through combination approaches designed to maximize immune activation while the primary tumor and lymphatic architecture remain intact. The faculty discuss how preserving the tumor microenvironment and nodal immune response prior to surgery may enhance the effectiveness of immune checkpoint blockade and improve long-term oncologic outcomes.

The panel also examines important distinctions between current and emerging perioperative strategies, including differences in treatment sequencing and the duration of therapy administered before and after radical cystectomy. In addition, the discussion highlights key questions surrounding the role of adjuvant therapy intensity, including whether some regimens may maintain efficacy while reducing postoperative treatment burden.

Finally, the faculty emphasize the importance of future clinical trial data in determining whether newer approaches can further improve pathologic complete response, event-free survival, and overall survival outcomes in MIBC. The panel discusses how these next-generation perioperative studies may help define more individualized treatment strategies while balancing efficacy, toxicity, and long-term disease control for patients with MIBC.

Our next episode, “Surgical Timing in the Perioperative Era of MIBC,” features the panelists discussing how perioperative therapies are influencing surgical timing, perioperative management, and postoperative recovery in muscle-invasive bladder cancer. The panel also highlights practical considerations for managing immune-related toxicities and integrating newer systemic therapies around radical cystectomy.