Multicenter phase 2 study of neoadjuvant atezolizumab with gemcitabine and cisplatin for muscle-invasive bladder cancer

Neoadjuvant gemcitabine and cisplatin (GC) followed by radical cystectomy (RC) is standard for patients with muscle-invasive bladder cancer (MIBC). On the basis of reported activity of atezolizumab (A) in metastatic bladder cancer, a multicenter phase 2 study tested the combination of GC plus A in the neoadjuvant setting of MIBC. The study found promising activity of the combination, warranting further study. Patients with downstaging to < pT2N0 (69% of patients) experienced improved relapse-free survival and overall survival compared to historical control of neoadjuvant chemotherapy alone.