Neoadjuvant Pembrolizumab and aMVAC for Non-Urothelial MIBC: Does This Combination Improve Outcomes?

At the 2025 American Society of Clinical Oncology Genitourinary Cancers Symposium, Petros Grivas, MD, PhD, Ali Khaki, MD, and Ruben Raychaudhuri, MD, discuss their phase II trial evaluating neoadjuvant pembrolizumab combined with accelerated methotrexate, vinblastine, doxorubicin, and cisplatin (aMVAC) for non-urothelial histologic subtype muscle-invasive bladder cancer. The authors provide insights into the study’s findings, which demonstrated a significantly higher pCR rate and encouraging survival outcomes compared to historical data. They also discuss the safety profile of the regimen, the rationale behind combining pembrolizumab with aMVAC, and the potential implications for future treatment strategies.