International Journal of Molecular Sciences Review Perioperative Systemic Treatment for Muscle-Invasive Bladder Cancer: Current Evidence and Future Perspectives In-Ho Kim 1 and Hyo-Jin Lee 2,* 1 Department of Internal Medicine, Division of Medical Oncology, Seoul St. Mary’s Hospital, The Catholic University of Korea College of Medicine, Seoul 06591, Korea;
[email protected] 2 Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon 35015, Korea * Correspondence:
[email protected]; Tel.: +82-42-280-8369; Fax: +82-42-257-5753 Abstract: Radical cystectomy is the primary treatment for muscle-invasive bladder cancer; however, approximately 50% of patients develop metastatic disease within 2 years of diagnosis, which re- sults in dismal prognosis. Therefore, systemic treatment is important to improve the prognosis of muscle-invasive bladder cancer. Currently, several guidelines recommend cisplatin-based neoad- juvant chemotherapy before radical cystectomy, and adjuvant chemotherapy is recommended in patients who have not received neoadjuvant chemotherapy. Immune checkpoint inhibitors have recently become the standard treatment option for metastatic urothelial carcinoma. Owing to their clinical benefits, several immune checkpoint inhibitors, with or without other agents (including other immunotherapy, cytotoxic chemotherapy, and emerging agents such as antibody drug conjugates), are being extensively investigated in perioperative settings. Several studies for perioperative im- munotherapy have shown that immune checkpoint inhibitors have promising efficacy with relatively low toxicity, and have explored the predictive molecular biomarkers. Herein, we review the current evidence and discuss the future perspectives of perioperative systemic treatment for muscle-invasive Citation: Kim, I.-H.; Lee, H.-J. bladder cancer. Perioperative Systemic Treatment for Muscle-Invasive Bladder Cancer: Keywords: bladder cancer; immunotherapy; perioperative systemic treatment Current Evidence and Future Perspectives.