π§ Not all bladder cancer patients need adjuvant IO!
In IMvigor011 (NEJM 2025), adjuvant atezolizumab was given only to patients with ctDNA positivity after cystectomy π§¬
π§ͺ Trial design:
β’MIBC pts post-cystectomy β serial ctDNA monitoring (Signatera)
β’ctDNA β randomized 2 : 1 β Atezolizumab π Placebo
β’ctDNA β just observed π
π Results (ctDNA β cohort):
β’π DFS: 9.9 mo vs 4.8 mo β HR 0.64 (P = 0.005)
β’β€οΈ OS: 32.8 mo vs 21.1 mo β HR 0.59 (P = 0.01)
β’β οΈ Grade 3-4 AEs: 28 % vs 22 % (fatal 2 % vs 0 %)
πΏ ctDNA β cohort: DFS 95 % at 1 yr & 88 % at 2 yrs β safely spared adjuvant therapy π
π‘ Takeaway:
First phase III trial showing OS benefit with adjuvant IO guided by ctDNA in MIBC!
Precision-based adjuvant era is here π
#OncoTwitter #ESMO25 #BladderCancer #Immunotherapy
@OncoAlert@myesmo@esmo_open@ASCO@NEJM
π Powles T et al. New Engl J Med. 2025
DOI: https://t.co/HsQDMl8ydD
Presented at #ESMO25:
In muscle-invasive bladder cancer, ctDNA-guided atezolizumab led to longer disease-free survival (9.9 vs. 4.8 months), as well as to longer overall survival (32.8 vs. 21.1 months), than placebo among ctDNA-positive patients. Full IMvigor011 phase 3 trial results: https://t.co/nbCPzF4Pxy
@myESMO
In the future we wonβt rely on pathology at surgery +/- luck to select patients for adjuvant treatment across cancers. Instead, the identification of residual disease by ctDNA/other biomarkers will be used. These data are a step towards that goal IMO. https://t.co/dPqlvr2rnV
@brooklynmarn takes down Omar in sudden death to advance to tonight's final at halftime of the Saints vs Thunder state semifinal FB game. She will take on the Thunder representative for *FREE* @ChickfilA for a year!! Let's go B!!
@missyMmcbeth These same people are concerned with creatine as well. Any lift can be dangerous if done incorrectly, just as any supplement can be dangerous if taken incorrectly. Most Drs. and Parents have very limited knowledge of weight training for performance.