The KEYNOTE-905/EV-303 trial investigated the combination of enfortumab vedotin and pembrolizumab as perioperative therapy in patients with invasive bladder cancer who were unable or unwilling to undergo cisplatin chemotherapy.[1][2] Patients in the experimental group received three cycles of combination therapy before surgery, then surgery (bladder and lymph node removal), followed by six more cycles of enfortumab vedotin and eight cycles of pembrolizumab.[1] Results showed that the combination of treatments significantly improved symptom-free survival and overall survival compared to surgery alone.[1][2] Median symptom-free survival was not reached in the combination group, while it was 15.7 months in the control group.[2] The safety profile of the combined treatment was consistent with previous data on each drug separately.[1] It is the first chemotherapy-free perioperative therapy to improve outcomes compared with radical cystectomy in patients ineligible for cisplatin chemotherapy, suggesting the potential to become a new standard of care.[2]