(UroToday.com) Neoadjuvant cisplatin-based chemotherapy prior to radical cystectomy and pelvic lymph node dissection improves survival compared to radical cystectomy and pelvic lymph node dissection alone for patients with muscle-invasive bladder cancer.1 Neoadjuvant gemcitabine-cisplatin is standard for patients with muscle-invasive bladder cancer and can result in pathologic downstaging to non-muscle-invasive bladder cancer (< pT2N0) at radical cystectomy, which correlates with improved survival. Based on the known activity of atezolizumab in metastatic bladder cancer, it is reasonable to assess the efficacy of combination gemcitabine-cisplatin + atezolizumab as neoadjuvant therapy. At the American Society of Clinical Oncology (ASCO) 2021 Annual Meeting, Dr. Samuel Funt and colleagues presented the results of their trial testing this combination in a phase II trial among patients with muscle-invasive bladder cancer.