Cystoscopy and cytology remain the standard for diagnosis, but a plethora of urinary biomarkers could someday be a useful adjunct to NMIBC surveillance.
Pembrolizumab demonstrated antitumor activity in patients with high-risk, papillary NMIBC who did not undergo radical cystectomy and did not respond to BCG.
Sacituzumab govitecan has demonstrated activity in patients with platinum-ineligible metastatic urothelial carcinoma whose disease progressed after checkpoint inhibitor therapy.
Neoadjuvant chemotherapy prior to radical cystectomy is not associated with an increased risk for major complications vs radical cystectomy alone, but it does increase the risk for bleeding requiring transfusion and sepsis.