Systemic induction therapy and the expanding frontier of bladder preservation in MIBC

A review published in Nature Reviews Clinical Oncology examines two recent phase II trials, INDIBLADE and SURE-02, which explore whether systemic induction therapy can enable bladder preservation in patients with muscle-invasive bladder cancer (MIBC). Traditionally, radical cystectomy or radiotherapy has been the standard of care for MIBC, but increasingly effective systemic regimens are raising the question of whether strong responders can safely avoid radical local treatment. The trials investigate response-guided strategies that could spare selected patients from surgery while maintaining oncological outcomes. If confirmed in larger phase III studies, this approach could fundamentally reshape the treatment landscape for MIBC by offering patients the possibility of retaining a functioning bladder.