(UroToday.com) Neoadjuvant cisplatin-based chemotherapy prior to radical cystectomy improves overall survival (OS) in muscle-invasive bladder cancer, but about half of patients are cisplatin-unfit or refuse it. Neoadjuvant immune checkpoint inhibitors can induce a high pathologic complete response rate (ypT0N0). The combination of anti-PD-1 (nivolumab) and anti-KIR (lirilumab) is hypothesized to be safe and has significant activity based on the complementary and possibly synergistic roles in regulating adaptive and innate immune response in muscle-invasive bladder cancer. KIR2DL modulates the immune microenvironment pathways and lirilumab is a fully human antibody that targets KIR2DL. At the 2021 American Society of Clinical Oncology (ASCO) annual meeting, Dr. Petros Grivas and colleagues presented the results of this phase Ib trial.