The KEYNOTE-905/EV-303 study investigated the combination of two drugs – enfortumab vedotin and pembrolizumab – in patients with invasive bladder cancer who were unable or unwilling to undergo standard cisplatin-based chemotherapy[1]. Patients received three cycles of this combination before surgery (bladder removal), followed by further treatment after surgery[1]. The results showed a significant improvement: two-year progression-free survival increased from 39.4% to 74.7% and overall survival from 63.1% to 79.7%[1]. The number of patients with complete pathological response (complete tumor disappearance) increased from 8.6% to 57.1%[1]. Treatment was feasible with similar operative rates in both groups[1]. Although combination therapy caused more side effects, they were consistent with the known safety profile of these drugs[1]. This study represents the first successful perioperative regimen for patients with invasive bladder cancer who cannot receive standard chemotherapy[3].