Advances in Perioperative Immunotherapy for Muscle-Invasive Bladder Cancer

Muscle-invasive bladder cancer (MIBC) presents considerable challenges due to its high recurrence rate following radical cystectomy and pelvic lymph node dissection. Standard treatment for cisplatin-eligible patients includes neoadjuvant cisplatin-based chemotherapy before surgery, which improves overall survival. However, recurrence remains common, and many patients are ineligible for cisplatin, presenting a need for alternative approaches.
Recent developments in perioperative management of MIBC focus on immunotherapy, particularly immune checkpoint inhibitors, integrated either as risk-adapted adjuvant therapy or universal perioperative treatment. Current research is evaluating the effectiveness and challenges of incorporating immunotherapy to enhance patient outcomes beyond traditional chemotherapy and surgery.
Ongoing clinical investigations and evolving treatment paradigms aim to optimize perioperative care for localized muscle-invasive urothelial carcinoma, with an emphasis on tailoring therapies to patient eligibility and disease risk. These advancements represent significant steps forward in managing this aggressive cancer type.