Dr. Brad McGregor

I think it really does.

It's important to have these discussions and talk with medical oncologists because I think intervening now, I mean, the magnitude of benefit with cisgender versus cisgender was higher than we saw with like the ABC analysis, right?

So, I mean, immunotherapy in the preoperative setting offers a huge advantage to these patients.

And, you know, if we extrapolate from melanoma where it does seem like giving immunotherapy when there's disease in place offers a benefit,

The same thing here.

We're just adding chemotherapy to that to even better disease control.

So I just think it's incredibly important that all patients and patients see us.

I will say we often see patients together.

So a patient comes in for a referral, they've maybe seen someone else, and they'll come in and a lot of patients are very educated and have ideas going in.

And so I think that we certainly talk about all options, right?

So for those small, single tumors, less than five centimeters, no

CIS, all those, we'd certainly think about it.

But I will say where we probably think more about bladder preservation is we start with systemic therapy.

And then those patients with exceptional responses were like, well, maybe instead of doing surgery, the patient's like, I have a really good response.

Do I really need to have my bladder out?

And I think that that's the unanswered question, right?

So I think that as our therapies get so much better in the paraplegic setting, like EVP has a path CR rate of over 50%, like unheard of.

Like if we can potentially cure patients with systemic therapy alone, that's going to be amazing.

So I think we're very early in this idea, but I think it's possible.

And so I think right now, again, that chemo-radiated situation is,