Graphical Reconstruction: Neoadjuvant Regimens for Cisplatin-Ineligible MIBC

New data presented at the 2026 American Society of Clinical Oncology Genitourinary Cancers Symposium suggests a potential benefit to a perioperative approach combining enfortumab vedotin and pembrolizumab for cisplatin-ineligible patients with muscle-invasive bladder cancer (MIBC). The research, led by Brigida Anna Maiorano, compared this regimen to neoadjuvant pembrolizumab alone.

The analysis, based on data from the Keynote-905, EV-303, and Pure-01 trials, focused on patients unable to receive cisplatin, a common chemotherapy agent used in MIBC treatment. Researchers utilized an independent patient-level data (IPD) comparative analysis to assess outcomes. The study, detailed in presentations at the ASCO GU 2026 conference, examined the impact of adding enfortumab vedotin to pembrolizumab before and after surgery.

According to the research, the combination therapy showed promise in this patient population. A publication in Cancers journal on December 17, 2025, authored by Maiorano and colleagues, detailed the management of muscle-invasive bladder cancer and highlighted the evolving treatment landscape. The study noted that adverse events were generally well-tolerated, with no unexpected toxicities observed in the SunRISe-4 trial, a phase II study of cisplatin-ineligible or refusing patients.

Maiorano, affiliated with the Department of Medical Oncology at IRCCS Ospedale San Raffaele in Milan, Italy, presented the findings. A YouTube video published March 8, 2026, features Maiorano discussing the potential of enfortumab vedotin plus pembrolizumab for this specific patient group. The video, posted by MedJ, has garnered 28 views as of the date of publication.

The research team’s function builds on previous investigations into neoadjuvant therapies for MIBC. The ongoing evaluation of these regimens aims to identify optimal treatment strategies for patients who cannot undergo cisplatin-based chemotherapy.