Case Report: early regression and bladder-intact survival after limited-course immunotherapy-based systemic therapy in two patients with clinically staged bulky muscle-invasive bladder cancer

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Radical cystectomy is the standard treatment for muscle-invasive bladder cancer, but bladder preservation strategies are investigational.
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Two male patients with bulky muscle-invasive bladder cancer showed early tumor regression after limited-course immunotherapy.
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Case 1 received tislelizumab with platinum-based chemotherapy, while Case 2 received toripalimab with disitamab vedotin.
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Both patients declined radical cystectomy despite marked regression and remained bladder-intact with no detectable recurrence after three years.
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The cases suggest early response kinetics may help identify exceptional responders for future bladder-preserving strategies.

Frontiers In Immunology

by Su Zhang, Hanghao Zhang, Xingwang Dong, Zhen Qi, Yingjun Ma, Hong Chang, Ye Li, Wei Zhang
June 8, 2026

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