Consolidation integration.

Immune checkpoint inhibitors are revolutionizing the treatment of advanced bladder cancer. As with many cancer revolutions, it’s occurring first in the metastatic setting. A population of particular interest are those with locoregional disease, with node-only mets often lumped in along with distant mets on trial. This all leaves the role of consolidative local therapy in the context of ICI largely unknown. Here is an intriguing review on what we know thus far and where we are headed. This includes harnessing the potential synergy of consolidative radiation with ICI. On the other hand, consolidative surgery may allow for post-induction genomic and/or pathologic changes to serve as a guide to optimizing maintenance therapy. TBL: Current trial designs should help define the best treatment paradigm for incorporating ICI and various consolidative treatment options for locally-advanced bladder cancer. | Necchi, Eur Urol 2020

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