Adjuvant Therapy in Patients after Cystectomy

Adjuvant cisplatin-based chemotherapy is standard of care for patients with muscle-invasive bladder cancer who have received no prior neoadjuvant therapy, are cisplatin-eligible, and have at least pT3 or lymph node-positive disease at the time of radical cystectomy. Carboplatin is inferior to cisplatin in bladder cancer and has not been extensively studied in the adjuvant setting. Adjuvant nivolumab and adjuvant pembrolizumab are recommended by National Comprehensive Cancer Network (NCCN) guidelines for patients with high-risk pathology on radical cystectomy.