Javier Molina Cerrillo, Attending Physician in Medical Oncology at Hospital Ramón y Cajal, shared a post on LinkedIn:
“Can we move from radical cystectomy to bladder preservation in muscle-invasive bladder cancer (MIBC)?
Our latest article, recently accepted in The Journal of Urology, explores a pivotal shift in the treatment paradigm:
- The emergence of perioperative enfortumab vedotin + pembrolizumab (EVP) is redefining systemic control, with striking improvements in event-free survival, overall survival, and pathologic complete response rates.
- At the same time, modern trimodality therapy (TMT) and immuno-radiotherapy strategies are demonstrating that bladder preservation is not merely an alternative in selected patients.
The key question we raise:
If systemic therapies can achieve deep and durable responses, is radical cystectomy always necessary?
We discuss:
- The evolving evidence from pivotal trials and immunotherapy combinations
- The role of biomarkers (e.g., ctDNA) and imaging in response-adapted strategies
- A future framework where surgery may be reserved for non-responders
The field is reaching an inflection point where cure and organ preservation may no longer be mutually exclusive.”
Title: From cystectomy to conservation: can perioperative EVP and immuno-RT redefine the standard of care in MIBC?
Authors: Javier Molina-Cerrillo, Matteo Santoni, Fernando Sabino Marques Monteiro, Teresa Alonso-Gordoa
Read the Full Article.
