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ESMO Asia 2023 | Perioperative management of advanced bladder cancer

Enrique Grande, MD, PhD, MD Anderson Cancer Centre Madrid, Madrid, Spain, discusses the perioperative management of patients with high-risk urothelial cancer. The current standard treatment remains cisplatin-based neoadjuvant chemotherapy (CT), with the VESPER trial (NCT01812369) introducing debate between gemcitabine/cisplatin (GC) and high-dose intensity methotrexate, vinblastine, doxorubicine and cisplatine (HD-MVAC) treatments. Additionally, the CheckMate 274 trial (NCT02632409) triggered the approval of nivolumab, whilst the AMBASSADOR trial (NCT03244384) introduced the efficacy of the PD-1 inhibitor pembrolizumab. The inconsistency of the data surrounding immune checkpoint inhibitors in advanced bladder cancer has led to doubts about their efficacy and reliability, but Dr Grande hopes to see AMBASSADOR’s results shed some light on this, and looks forward to results on both CT with immunotherapy and enfortumab vedotin with immunotherapy as a neoadjuvant treatment in both cisplatine eligibility groups next year. This interview took place at the European Society for Medical Oncology (ESMO) Asia 2023 Congress in Singapore.

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