Oncology Today with Dr Neil Love Non-Muscle-Invasive and Muscle-Invasive Bladder Cancer — Proceedings from a Session Held Adjunct to the 2026 ASCO Genitourinary Cancers Symposium
Mar 25, 2026
Prof Andrea Necchi, urothelial clinical investigator focused on novel intravesical systems like TAR‑200. Dr Shilpa Gupta, clinician-researcher in muscle-invasive disease and perioperative systemic therapy. Dr Matthew D Galsky, medical oncologist expert in ctDNA and perioperative trials. They discuss intravesical innovations, PD‑1 plus BCG strategies and sequencing, perioperative EV‑pembro data, and ctDNA‑guided adjuvant decision making.
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Interpret CIS Subgroup Results With Caution
- Don’t assume CIS uniformly benefits from PD‑1 add‑on; consider control arm performance and trial differences before generalizing.
- Terence Friedlander noted POTOMAC's unusually high CIS CR in the control arm (93%), which may obscure real PD‑1 effects.
EV‑Pembrolizumab Drives High pCR And Survival Signals
- EV‑pembrolizumab neoadjuvant trials report unprecedented pathologic CR rates (~57%) and large EFS/OS benefits, prompting discussion about de‑escalating adjuvant therapy or pursuing bladder preservation.
- Shilpa Gupta noted high grade‑stage patients and older/frail cohorts still benefited across subgroups in KEYNOTE‑905/EV data.
Use Tumor‑Informed ctDNA To Inform Adjuvant Decisions
- Use tumor‑informed Signatera ctDNA (where available) to help shared decision‑making about adjuvant therapy; treat ctDNA‑positive patients and consider close surveillance for ctDNA‑negative.
- Betsy Plymick ordered Signatera to reassure a patient with negative ctDNA and clear imaging, then opted for observation.