Dr Michiel van der Heijden speaks to ecancer about the KEYMAKER-U04 substudy 04B.

The study compared enfortumab vedotin plus pembrolizumab alone versus combinations that also included LAG-3 or TIGIT inhibitors.

Results showed that adding these additional immune therapies did not meaningfully improve response rates or clinical outcomes compared with the standard regimen.

Safety profiles were generally similar, although higher rates of immune-related side effects were observed with the combination approaches.

Dr van der Heijden highlights what these findings mean for current first-line treatment strategies and the future role of combination immunotherapy in advanced bladder cancer.