Novel Neoadjuvant Therapies in MIBC

In this OncLive Peer Exchange moderated by Dr. Thomas Powles, leading oncologists — including Drs. Alan Tan, Guru Sonpavde, Petros Grivas, and Joaquim Bellmunt — discussed advances in muscle-invasive bladder cancer (MIBC) management, focusing on novel perioperative approaches and biomarker integration. The panel reviewed current standards such as cisplatin-based neoadjuvant chemotherapy with perioperative durvalumab, which improves pathologic complete response and overall survival. Attention then shifted to the SunRISe-4 trial, evaluating TAR-200, a sustained-release intravesical gemcitabine device, combined with cetrelimab in cisplatin-ineligible patients. Results showed encouraging pathologic complete responses (38%) and ctDNA clearance correlated with improved relapse-free survival. The experts emphasized TAR-200’s potential role alongside systemic immunotherapies to enhance bladder preservation strategies. However, they noted the need for further data to clarify long-term outcomes and optimal integration within an increasingly crowded therapeutic landscape for MIBC.