NEJM 4 2026 Perioperative Enfortumab Vedotin and Pembrolizumab in Bladder Cancer

This study evaluates a new treatment strategy for patients with muscle-invasive bladder cancer who cannot undergo standard cisplatin chemotherapy, a group traditionally limited to surgical intervention. By combining an antibody-drug conjugate with an immunotherapy agentboth before and after surgery, researchers observed a dramatic increase in event-free and overall survival compared to surgery alone. Most notably, over half of the patients receiving this combination therapy achieved a pathological complete response, meaning no evidence of the tumor remained at the time of surgery. Although the dual-drug regimen introduced more significant side effects, the findings suggest a paradigm shift in providing a more effective curative path for this high-risk patient population