Practical Integration of Perioperative Therapy in MIBC

In the final episode, “Practical Integration of Perioperative Therapy in MIBC,” the panelists explored key takeaways and practical considerations for incorporating perioperative treatment strategies into the management of muscle-invasive bladder cancer (MIBC). The expert urologic oncology faculty reflected on how recent advances in immunotherapy- and antibody-drug conjugate-based regimens are reshaping surgical workflows, multidisciplinary collaboration, and perioperative decision-making in modern clinical practice.

Throughout the discussion, the panel emphasized the importance of maintaining close communication between urologists and medical oncologists as perioperative care becomes increasingly individualized and complex. The faculty discussed the need for surgeons to become familiar with treatment-related adverse events associated with newer systemic therapies, including immune-related toxicities and neuropathy, while continuing to approach radical cystectomy with confidence despite evolving treatment paradigms.

The panelists also reinforced that perioperative therapies such as the NIAGARA and EVP approaches have not fundamentally altered the safety or technical feasibility of radical cystectomy. In addition, the discussion highlighted that many patients who historically would have proceeded directly to surgery, particularly those who are cisplatin-ineligible, may now benefit from systemic therapy prior to cystectomy.

Finally, the faculty emphasized that surgery remains a critical component of currently approved perioperative treatment paradigms and that bladder preservation strategies should continue to be pursued within clinical trial protocols. The panel concluded by underscoring the importance of continued collaboration, clinical trial enrollment, and ongoing research efforts to improve outcomes for patients with variant histologies and higher-risk forms of MIBC. Thank you for watching this peer exchange series on MIBC. Please subscribe to our newsletter for information on upcoming video series.