(UroToday.com) Previous studies have shown that a pathological complete response is achieved in ~30-40% of patients with cisplatin-based neoadjuvant chemotherapy for muscle-invasive bladder cancer and is associated with favorable outcomes. Unfortunately, pathological staging is only determined after the bladder is already removed. Transurethral resection of bladder tumor (TURBT) plus systemic therapy has been known for decades to achieve durable bladder-intact survival in a subset of patients with muscle-invasive bladder cancer but efforts to advance this paradigm have been complicated by: