The combination of Padcev (enfortumab vedotin) and Keytruda (pembrolizumab) significantly improved event-free survival and overall survival in patients with muscle-invasive bladder cancer (MIBC) eligible for cispilatin[1][3][5]. These results come from an interim analysis of the phase 3 clinical trial EV-304 (also KEYNOTE-B15), which compared perioperative treatment with this combination to standard neoadjuvant chemotherapy with gemcitabine and cispilatin[1][3][5]. The study met the primary objective—a clinically significant and statistically significant improvement in event-free survival—and key secondary objectives, including an improvement in pathologic complete response, meaning a higher proportion of patients without detectable cancer in the surgical specimen after surgery[1][3][5]. Treatment was administered before surgery (neoadjuvant) and after bladder removal (adjuvant)[1][3]. The safety profile of the combination corresponded to previous data, with no new problems[1]. This combination represents the first platinum-free chemotherapy to improve perioperative survival in cisplatin-favorable MIBC patients[3][5].