Trimodal Therapy for Muscle Invasive Bladder Cancer: An Update on Current Practices and Future Directions

Bladder preservation utilizing maximal transurethral resection of the bladder tumor, radio sensitizing chemotherapy, and targeted pelvic radiation (known as Trimodal Therapy (TMT) is a validated treatment alternative for muscle invasive bladder cancer (MIBC) for appropriately selected and counseled patients. Long term results of the original studies that described TMT and continuing advancements in radiation techniques and chemo/immunotherapy regimens support its place in international treatment guidelines as more than a second line therapy for cystectomy ineligible patients. This review will provide an up-to-date discussion on the evidence supporting TMT for managing MIBC.