Patients with muscle-invasive bladder carcinoma (MIBC) typically receive cisplatin-based chemotherapy prior to radical cystectomy, although not all patients are eligible for cisplatin. Several ongoing trials are testing immune-checkpoint inhibitors (ICIs) in this setting, including the phase II PURE-01 trial of pembrolizumab. Now, 3-year follow-up data from this trial confirm the efficacy of neoadjuvant pembrolizumab in MIBC.