In the SURE-01 trial, nearly a third of patients declined radical cystectomy after strong responses to sacituzumab govitecan. This patient-driven decision highlights a significant, growing interest in bladder preservation, pushing the field to validate less invasive approaches for select patients.
The SURE-01 trial's data suggests non-luminal subtypes and low TOP1 expression are linked to better outcomes with sacituzumab govitecan. This finding points toward a future where molecular profiling, not just treatment ineligibility, could guide personalized neoadjuvant therapy selection for patients.
The SURE-01 trial experienced two early deaths, leading to mandatory dose reductions and growth factor support. While this made the ADC sacituzumab govitecan more manageable, it highlights its narrow therapeutic window and the critical need for proactive toxicity management protocols from the outset.