COMPLETE PATHOLOGICAL RESPONSE?

I received my third negative circulating tumor DNA (Signatera) test today.
I discovered my disease - which turned out to be locally advanced muscle invasive bladder cancer (MIBC) - 390 days ago.
I had a transurethral resection of the bladder tumor (TURBT) 15 days later and began treatment with enfortumab vedotin + pembrolizumab (EV/pembro or Padcev/Keytruda) 89 days after discovering the disease.  The tumor sample was used by Natera to design my Signatera test to find evidence of residual disease by detecting tumor DNA shed into the blood from anywhere in the body. 
3 months after my TURBT, 1 month after beginning treatment, I underwent an endoscopic procedure to remove and possibly replace a stent in my right ureter placed during the TURBT due to the tumor obstructing flow from my right kidney.  The kidney flow was now brisk and there was no evidence of my primary tumor in the bladder.
84 days after beginning treatment (4 cycles) PET/CT now showed no significant uptake in my previously active pelvic lymph nodes or evidence of new metastatic disease.  Two follow-up CT scans with contrast would also show no new significant findings.
Given the good results, due to low grade adverse effects, we suspended the Padcev component after 7 cycles and have continued with Keytruda alone (currently 7 more cycles).  Sensation in my fingertips and toes, sense of taste and hair have since returned.
29% of the participants in the EV 302 trial (that led to the accelerated approval of EV/pembro as a first line treatment for patients with locally advanced or metastatic muscle invasive bladder cancer) had a complete pathological response.  I have no plans to pursue removal of or chemoradiation to the bladder.  I am working to see that more high responders are followed to see how durable the response is.  In the meantiume I hope to encourage more patients try EV/pembro as their first line treatment before pursuing radical cystectomy or bladder sparing with trimodality therapy.  The vision was articulated by a leader in the field - Dr. Shilpa Gupta - at the recent EMSO 2024 meeting