The potential of disitamab vedotin in bladder preservation during neoadjuvant therapy for bladder cancer: A comparative analysis with the GC regimen.

e16585 Background: The goal of neoadjuvant therapy for bladder cancer is to improve pathological outcomes and provide patients with the opportunity to preserve the bladder. Disitamab Vedotin, a HER2-targeted antibody-drug conjugate (ADC), has shown significant efficacy in metastatic urothelial carcinoma. This study aims to evaluate the potential of Disitamab Vedotin in promoting bladder preservation during neoadjuvant therapy for bladder cancer. Methods: A retrospective analysis of clinical data from 44 bladder cancer patients was conducted. Patients were divided into two groups: Group A (Disitamab Vedotin monotherapy or combined with immunotherapy, n = 21) and Group B (GC regimen, n = 23). The primary endpoints included complete response (CR) rate, bladder preservation rate, and adverse events. Results: The CR rate in Group A was significantly higher than in Group B (76.2% vs. 39.1%, P = 0.017). The bladder preservation rate was also higher in Group A (66.7% vs. 34.8%, P = 0.069). Group A had a lower incidence of hematologic toxicities, including leukopenia (38.1% vs. 73.9%, P = 0.032) and neutropenia (19.0% vs. 52.2%, P = 0.031). Other adverse events, such as hepatotoxicity and peripheral neuropathy, showed no significant differences between the two groups. Severe adverse events (Grade 3–4) were rare, indicating good tolerability for both regimens. Conclusions: The Disitamab Vedotin regimen demonstrated better efficacy and safety compared to the GC regimen in neoadjuvant therapy for bladder cancer. Its higher CR rate and potential for bladder preservation make it a promising option for organ-sparing treatment. However, given the small sample size and the retrospective nature of this study, further validation through large-scale, multicenter prospective studies is required.