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Muscle-Invasive Bladder Cancer (MIBC) — Treatment
Muscle-invasive
bladder cancer
cT2–4a N0 M0
Cisplatin-eligible
Adjuvant (high-risk, no neoadj IO)
Bladder preservation
Cisplatin-ineligible
Neoadjuvant
ddMVAC or GC → cystectomy
cisplatin-based
Perioperative
Durvalumab + chemo
NIAGARA ↗
Adjuvant
Nivolumab
CheckMate 274 ↗
Trimodality
Max TURBT + chemoRT
selected patients
Definitive
Cystectomy or chemoRT
per fitness