ASCO 2025 | Phase II trial results guide a new multimodal treatment approach to MIBC
Chiara Mercinelli, MD, IRCCS San Raffaele Hospital, Milan, Italy, discusses key factors guiding patient selection for intensive multimodal therapy in muscle-invasive bladder cancer (MIBC). Immunotherapy is a cornerstone of MIBC treatment, but since not all patients respond equally and predictive biomarkers are not always available, a combination of immunotherapy and chemotherapy is often used. In particular chemotherapy regimens suited for patients who are unfit for cisplatin-based combinations. The neoadjuvant use of nivolumab and nab-paclitaxel, as studied in the Phase II NURE-Combo trial (NCT04876313), helps assess treatment response and informs decisions about the potential for bladder preservation. This interview took place during the 2025 American Society of Clinical Oncology (ASCO) Meeting in Chicago, IL.
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Transcript
How do you know that immunotherapy must be present in the therapy of patients affected by muscle-invasive bladder cancer? Of course, not all patients benefit from immunotherapy, so by now if we don’t have a biomarker, we need to combine chemotherapy plus immunotherapy. In particular, the chemotherapy we’ve chosen is good for those patients who are unfit for cisplatin-based combinations...
How do you know that immunotherapy must be present in the therapy of patients affected by muscle-invasive bladder cancer? Of course, not all patients benefit from immunotherapy, so by now if we don’t have a biomarker, we need to combine chemotherapy plus immunotherapy. In particular, the chemotherapy we’ve chosen is good for those patients who are unfit for cisplatin-based combinations. And then, with a strong collaboration with our urologists, we try to obtain the best results possible in terms of pathological complete response, in terms of safety after surgery. And sometimes we are able to obtain also a bladder-sparing approach. So we tend to save the bladder and those patients will really respond after neoadjuvant therapy.
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