Sia Daneshmand, MD, on KEYNOTE-905’s impact in bladder cancer

In a recent interview with Urology Times®, Sia Daneshmand, MD, highlighted the “game-changing” impact of the KEYNOTE-905 trial in the bladder cancer space. Overall, the trial evaluated the combination of enfortumab vedotin plus pembrolizumab given before and after surgery vs observation in patients with cisplatin-ineligible muscle-invasive bladder cancer.

The study is the first to demonstrate a survival benefit for a drug regimen in this setting, with favorable tolerability and no new safety signals.¹ Based on these findings, the combination recently received approval and is rapidly becoming a new standard of care, Daneshmand noted.

Daneshmand is a professor of urology at the Keck School of Medicine of the University of Southern California (USC) and the director of clinical research at USC Norris Comprehensive Cancer Center.

Daneshmand also emphasized the evolving, highly collaborative role between urologists and medical oncologists as perioperative systemic regimens expand.

“The 2 entities are no longer separate fields. We’re having a lot of multi-disciplinary discussions,” he noted. “Medical oncologists are getting to know the therapies for non–muscle invasive bladder cancer, and we as urologic oncologists are getting to know a lot of the systemic therapies, because these come into our discussions with the patients as to where we should direct them, both pre-surgery and following surgery, in terms of perioperative systemic therapy.”

Overall, he explained that increasing use of ctDNA to guide treatment decisions, broader familiarity with systemic therapies across specialties, and growing interest in bladder preservation strategies are driving closer multidisciplinary coordination to optimize care before and after surgery.

REFERENCE

1. Perioperative (periop) enfortumab vedotin (EV) plus pembrolizumab (pembro) in participants (pts) with muscle-invasive bladder cancer (MIBC) who are cisplatin-ineligible: The phase III KEYNOTE-905 study. Presented at: 2025 European Society for Medical Oncology Congress. October 17-21, 2025. Berlin, Germany. Abstract LBA2. https://s3.eu-central-1.amazonaws.com/m-anage.com.storage.esmo/static/esmo2025_abstracts/LBA2.html.pdf