Bladder-Sparing Treatment With Disitamab Vedotin and Toripalimab With or Without Pelvic Lymph Node Dissection in Bladder Cancer

Inclusion Criteria:

1. Male or female participants aged 18 years or older.
2. Histologically confirmed bladder urothelial carcinoma.
3. Clinical stage cT2-3N0M0 according to the AJCC 8th edition TNM staging system.
4. HER2 expression of IHC 2+ or higher.
5. Participants who decline radical cystectomy as assessed by the investigator.
6. Adequate organ function as defined in the study protocol.
7. Ability to understand and willingness to sign written informed consent.

Exclusion Criteria:

1. Known allergy or hypersensitivity to disitamab vedotin, toripalimab, their excipients, or other monoclonal antibodies.
2. Prior radiotherapy for bladder cancer.
3. Prior anticancer treatment that may affect efficacy assessment, as defined in the study protocol.
4. Pregnant or breastfeeding women.
5. Any serious uncontrolled disease or medical condition that, in the investigator's judgment, would make participation inappropriate.
6. Participation in another interventional clinical trial that may interfere with this study.