The Emerging Perioperative Era in MIBC with the NIAGARA Trial

In this episode, “The Emerging Perioperative Era in MIBC with the NIAGARA Trial,” the expert faculty explore how the NIAGARA trial is reshaping the treatment landscape for muscle-invasive bladder cancer (MIBC). The panel reviews the clinical data supporting perioperative durvalumab plus gemcitabine-cisplatin (GC) in cisplatin-eligible patients, including findings related to pathologic complete response, event-free survival, overall survival, and safety, and discusses how these outcomes are influencing treatment strategies in clinical practice.

Throughout the discussion, the panelists examine the growing role of perioperative therapy and how combining immunotherapy with traditional cisplatin-based chemotherapy is changing the management of MIBC. The faculty discuss how these newer treatment paradigms compare with historical approaches, how clinicians are approaching treatment selection in cisplatin-eligible and ineligible patients, and the broader implications of integrating systemic therapy before and after radical cystectomy.

The discussion also highlights the surgical implications of perioperative therapy, including changes in tissue characteristics encountered during surgery and how these therapies may influence operative planning and postoperative recovery. In addition, the panel shares practical perspectives on adapting surgical workflows, preparing for radical cystectomy following systemic therapy, and maintaining confidence in the operating room as perioperative approaches continue to evolve in MIBC management.

The next episode in this series, “Perioperative Therapy Expansion in Cisplatin-Ineligible MIBC,” features the panelists discussing how emerging perioperative therapies are reshaping treatment selection for cisplatin-ineligible patients with muscle-invasive bladder cancer. The panel also highlights which patients may still proceed directly to surgery and how these decisions are evolving in modern clinical practice.