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Published 01 April 2021 Adjuvant therapy trials for urothelial carcinoma have traditionally been challenging to perform.  Radical cystectomy is a significantly morbid procedure that leads to high complication and readmission rates.   Hence, many patients are not fit to receive any adjuvant therapy after definitive local therapy due to a compromised health situation. At this time, neoadjuvant chemotherapy is still the definitive standard. 1 However, not all patients receive neoadjuvant therapy for a multitude of reasons.  For those who did not receive neoadjuvant cisplatin combination chemotherapy, common sense warrants strong consideration of adjuvant therapy as long as a patient is fit and interested. However, we have extremely limited evidence on what to do if a patient has residual muscle invasive disease after prior receipt of neoadjuvant combination cisplatin-based chemotherapy.  This is clearly an unmet need population due to the very poor prognosis.

Fred hutchinson cancer research centerUnited statesUniversity of washingtonComunidad autonoma de catalunaEvan yuClinical research divisionClinical research serviceSpanish oncology genitourinary groupSeattle cancer care allianceClinical researchFred hutchinson cancer research consortiumUniversity of washington school medicineDivision of oncologyDepartment of medicineAdvanced bladder cancerTherapy trials