Durvalumab Findings Will Change Bladder Cancer Care

Standard treatment for muscle-invasive bladder cancer involves neoadjuvant chemotherapy followed by radical cystectomy. But findings from the 1,063-patient phase III NIAGARA trial will change that practice. At the ESMO Congress 2024, held in Barcelona, Spain, September 13–17, researchers reported that patients who received the PD-L1 inhibitor durvalumab (Imfinzi; AstraZeneca) and cisplatin–gemcitabine prior to surgery, followed by adjuvant durvalumab, experienced statistically significant and clinically meaningful improvements in survival compared with neoadjuvant cisplatin–gemcitabine alone (N Engl J Med 2024 Sep 15 [Epub ahead of print]). The estimated event-free survival at 24 months among the patients who received durvalumab was 67.8% and 59.8% in the group that received standard therapy. Estimated overall survival at 24 months was 82.2% and 75.2%, respectively. Knowing the difficulties patients face, oncologists at the meeting responded to the findings, which were simultaneously published, with sustained, enthusiastic applause.