Enfortumab Vedotin and Pembrolizumab in People With Bladder Cancer

This trial combines two drugs — enfortumab vedotin (an antibody-drug that targets cancer cells) and pembrolizumab (an immunotherapy) — given before bladder removal surgery in patients with muscle-invasive bladder cancer. The goal is to shrink the tumor before surgery and improve long-term outcomes. **You may be eligible if...** - You are 18 or older with muscle-invasive bladder cancer (or cancer of the ureter, kidney lining, or urethra) - Your cancer is confined locally or has spread to nearby lymph nodes but not to distant organs - You have not yet received treatment for muscle-invasive or metastatic disease - You are in generally good health (ECOG 0 or 1) **You may NOT be eligible if...** - You have severe heart failure or had a heart attack or stroke within 6 months - You have an active autoimmune disease or are on immunosuppressive therapy - You have active hepatitis B or C, or poorly controlled HIV - You have pre-existing nerve damage (grade 2 or higher neuropathy) - You are pregnant or breastfeeding Talk to your doctor to see if this trial is right for you.