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VESPER Commentary






                • ddMVAC as new SOC for NAC



                • Number of cycles of chemo


                       • Should we use 6 cycles for NAC?



                • Toxicity: Only 60% of ddMVAC patients received 6 cycles

                   (84% received 4 cycles of Gem/Cis)



                       • Toxicity and pathological response reported by Pfister et al, Eur

                          Urol 2021 (February)








                • Other points:


                       • ddMVAC as SOC based on secondary outcome?


                       • Primary outcome not met


                       • 3 yr PFS is a more clinically important endpoint than pCR
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