For years, the standard treatment for muscle-invasive bladder cancer (MIBC) was radical cystectomy (RC), preceded by neoadjuvant cisplatin-based chemotherapy (NAC), if tolerable. Currently, the National Comprehensive Cancer Center (NCCN) has two category 1 recommendations for patients with cT2-T4aN0 MIBC: NAC followed by cystectomy, and trimodal therapy (TMT).1

Muscle-invasive bladder cancer (MIBC) represents 1/3 of the approximately 81,000 newly diagnosed bladder cancer cases in the US each year.1 Cisplatin-based neoadjuvant chemotherapy (NAC) followed by radical cystectomy (RC) has been the traditional and most widely used management approach to MIBC.