Adjuvant pembrolizumab nearly doubles cancer-free time in high-risk, muscle-invasive bladder cancer patients post-surgery compared to observation, according to a large clinical trial published in the New England Journal of Medicine. The study found pembrolizumab effective regardless of PD-L1 status, with patients remaining cancer-free for a median of 29.6 months versus 14.2 months with observation. The trial, led by the National Institutes of Health, suggests pembrolizumab as an alternative to cisplatin-based chemotherapy for these patients.