ctDNA-guided adjuvant atezolizumab improves OS in MIBC
Published on 20 October 2025
Prof Powles talks to ecancer at ESMO 2025 about data he presented from the phase III IMvigor011 trial.
This evaluated a circulating tumour DNA (ctDNA)-guided approach to adjuvant therapy in patients with high-risk muscle-invasive bladder cancer (MIBC) after cystectomy.
Among 761 participants enrolled in ctDNA surveillance, 250 ctDNA-positive patients were randomized to atezolizumab or placebo. At a median follow-up of 16.1 months, atezolizumab significantly improved disease-free survival (HR 0.64; P = 0.0047) and overall survival (HR 0.59; P = 0.0131) versus placebo, with a manageable safety profile.
Patients who remained ctDNA-negative had good outcomes without adjuvant therapy (2-year DFS = 88.4%), supporting ctDNA as a biomarker to individualize post-surgical treatment in MIBC.
See experts discuss more on bladder cancer here.