NEO-BLAST

An aspect marked incomplete is a question the public commentary did not let us answer. We show it rather than hide it.

Screened window

Feb 17, 2025 → Oct 31, 2026

Cited window

Feb 17, 2025 → Oct 31, 2026

Retrieved

Oct 31, 2026

Title

Active Surveillance Versus Definitive Local Therapy for Patients Showing Clinical Complete Response Following Neoadjuvant Therapy for Muscle Invasive Bladder Cancer

Registry

NCT06537154

Study IDs

H23-02447

Sponsor

Peter Black

Collaborators

University of British Columbia, Canadian Institutes of Health Research (CIHR)

Design

Phase 2/Phase 3 · Interventional, randomized, parallel

Status

Recruiting

Enrollment

688 estimated

Registered

2024-08-05

Start

2025-07-28 actual

Primary completion

2028-12-31 estimated

Primary endpoint

Proportion of patients found to have a cCR and randomized on the number of patients enrolled (pilot-RCT ; phase 2)

Interventions

2 registered

This report does not judge efficacy, estimate HCP prevalence or consensus or give treatment advice.

• –Discussion that does not name the trial may be missing from this edition.
• –Not yet captured in this edition: a view on cystectomy standards and neoadjuvant systemic therapy informing bladder-preservation decisions in muscle-invasive bladder cancer.
• –Not yet captured in this edition: a view on rigorous complete-response assessment, consistent definitions, and further evidence needed for response-guided bladder preservation.
• –Not yet captured in this edition: a view on neoadjuvant treatment amendments and adjuvant treatment switching in muscle-invasive bladder cancer.
• –Not yet captured in this edition: a question about early stopping and interpretation of the available neoadjuvant evidence.
• –Not yet captured in this edition: a view on pragmatic adaptation of neoadjuvant treatment studies and trade-offs between timely access and treatment heterogeneity.
• –Some passages in the sources used in this report were not fully assessed for clinician views, so a view there may be missing from this edition.
• –73 statements in the sources reviewed for this edition are about other patients or topics, or only mention the trial, and are not counted.
• –Further source limits apply, so some matching discussion may be missing.
• –The sources describe planned NEO-BLAST methods and conditional future implications, not comparative evidence establishing surveillance as non-inferior.
• –Some portions of reviewed recordings and threads were not fully assessed for relevant views. The report therefore cannot claim exhaustive coverage despite including substantial connected discussion.
• –Missing connected material includes contrasting disappointment about an unpresented pembrolizumab arm, reasoning about limited expected incremental neoadjuvant benefit from single-agent checkpoint treatment, experience with Ambassador and speculation about immature data. These absences limit interpretation of the available systemic-treatment evidence.
• –Other missing discussion concerns uncertainty about whether another arm had reported, a question about early stopping, and praise for adapting an existing study to include EV–pembrolizumab with faster access, time saved and acknowledged heterogeneity. Another relevant missing view lacks enough detail to characterize.
• –The separate discussion of whether treatment was standard throughout the perioperative study, including at its start, and the objection to changing a comparator mid-study is not represented. The account of contemporary surgery-control patients must not be read as a complete assessment of comparator selection.
• –Coverage is also incomplete for a speaker's connected discussion of MODERN amendments and adjuvant treatment changes, including LAG-3 treatment with relatlimab and its melanoma-approval context. Some linked discussion of systemic-treatment efficacy, cystectomy's standard role, rigorous and uniform cCR assessment, consistent definitions and the need for further study is absent. These gaps limit the completeness of the treatment-switch and response-selection themes.
• –Some speech cannot be assigned to a named participant. It is attributed only to the recording and must not be counted as an additional independent clinician or assumed to contradict a named participant in that recording.
• –Relayed presentation or podcast views remain the original party's reported views, not the relayer's endorsement. Reposts and parallel-language summaries do not establish independent agreement.
• –Several clinical roles are not independently established in the sources reviewed. Source-described roles or trial involvement are identified as such; identity information does not establish who spoke otherwise unattributed words.
• –Precursor-study figures are speakers' reports or interpretations, sometimes approximate or uncertain. They are not NEO-BLAST outcomes and do not establish causation, cross-study equivalence or validated selection rules.
• –Descriptions of the pilot's 25% threshold differ in their denominator wording. A speaker and the registry describe the joint cCR-and-randomization proportion among enrolled patients; the protocol abstract phrases acceptance among patients with cCR.
• –The precise Health Canada approval timing for EV–pembrolizumab remains unclear, and easier attainment of the feasibility target is a speaker's expectation rather than a reported feasibility result. The passage describing the 10% non-inferiority margin does not specify its endpoint or timepoint.
• –No separate protocol file was available from the registry. The registry methods and protocol publication provide context, not a complete assessment of every operational or safety question.
• –Source dates are publication or post dates unless an event is explicitly named. They cannot establish a readout date, a session date or a change in a person's position.
• –The report describes this edition's reviewed discussion, not the prevalence of views among HCPs or all public commentary.

How reports are built and checked: Methods.

Last checked for new commentary Oct 31, 2026. A new or changed finding gets a new version number; added evidence alone is a smaller update. No corrections.

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