Abstract Metastatic muscle-invasive bladder cancer carries a poor prognosis despite recent therapeutic advances. Enfortumab vedotin plus pembrolizumab (EVP) is now the standard first-line treatment for metastatic urothelial carcinoma. However, the role of local consolidative treatment after deep systemic response remains undefined. We report the case of a 59-year-old man with de novo metastatic bladder cancer (cT3N1M1) treated with first-line EVP. After 10 cycles, imaging demonstrated a sustained complete metabolic response. Consolidative radical cystoprostatectomy with Bricker diversion confirmed a complete pathological response (ypT0N0M0R0). This case highlights that deferred local consolidative surgery may be considered in carefully selected metastatic patients achieving durable responses to modern systemic therapies.
Lefranc et al. (Tue,) studied this question.
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