Efficacious neoadjuvant therapy is an unmet need in cisplatin-ineligible patients with muscle-invasive bladder cancer (MIBC). Several early-phase clinical trials have investigated the use of immune checkpoint inhibitors (ICIs) in this context, with some promising results. A study in Nature Medicine set out to test whether the efficacy of ICIs could be improved in combination with other therapies.

Cretostimogene grenadenorepvec is an oncolytic immunotherapy, which also selectively expresses granulocyte–macrophage colony-stimulating factor (thought to boost cancer control). The authors conducted a phase Ib trial of intravesical cretostimogene and nivolumab (an ICI) to test the safety and efficacy of this combination.