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Background: Pembrolizumab leads to responses in 20-30% of metastatic bladder cancer patients. Irradiation of bladder cancer cells in-vitro and in-vivo leads to upregulation of PD-L1, and in immunocompetent mouse models blockade of PD-L1 leads to longer tumour growth delay following irradiation. A trial of chemoradiotherapy with pembrolizumab in muscle invasive localised bladder cancer will assess safety and synergy of the combination.
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