To be clear, here is the rest of what the article title should be...
> ...for individuals with high-risk non-muscle-invasive bladder cancer whose cancer had previously resisted treatment
> ...for individuals with high-risk non-muscle-invasive bladder cancer whose cancer had previously resisted treatment
Part of the reason why is that it's difficult to convince patients or providers to reach for the experimental treatment in trial before the current standard of care. Many first-line treatments began as second/third-line or salvage treatments before experiencing line promotion or (if surgery is involved) neoadjuvant promotion. Keytruda is a good example of this progression in action.