
ESMO 2026
2026 年 10 月 23–27 日 · Madrid · 共 4873 条
VOLGA
★★★65 人 · 93 条
本事件热度走势
当前热度 2·可比范围峰值 3(10月26日 21:00)·近 24 小时可比范围变化 –·当前参与者 4
VOLGA是一项III期试验(n=695),在顺铂不合适或拒绝顺铂的肌层浸润性膀胱癌(MIBC)中评估围手术期度伐利尤单抗(D)±特雷梅利尤单抗(T)联合3个周期新辅助恩福妥单抗维替妥(EV),对照为根治性膀胱切除后观察或已获批的辅助治疗。就已发表文献而言,本次清单中没有与该方案直接对应的III期研究可引,泌尿生殖方向仅有Claudin-6 ADC ixotatug vedotin在生殖细胞肿瘤的单药早期探索[2],靶点与瘤种均不同,只能算类别背景。真正撑起“围手术期ADC+IO”语境的NIAGARA不在文献清单里,“围手术期EV-帕博利珠单抗已是MIBC标准”的说法来自现场医生;同场报告的KEYNOTE-866(吉西他滨/顺铂+帕博利珠单抗)未达主要终点,pCR 44.4%对35.8%,EFS与OS均不显著,反衬出VOLGA的分量。
ESMO26总统专场由Tom Powles报告,结果同步见刊NEJM。EVD组(3周期新辅助EV+围手术期度伐利尤单抗)对比单纯膀胱切除,EFS HR 0.51、OS HR 0.58;pCR为40-45%,ctDNA清除率60%;辅助IO使用率高、神经病变发生率低。三药EVDT组EFS HR 0.61,OS在此中期分析未达显著(HR 0.77,仍在分析中);EVDT的G3/4毒性较EVD臂高10%,且EV给药更少,报告者直言“更多不一定更好”,认为treme的加入部分影响了EV的给药,可能解释结果相对温和。现场医生进一步点出“3个术前EV剂量就够”“没有辅助EV也有OS获益,术后是否还需要EV是未来试验的重要问题”,并有人直接称之为新SOC。
主站新闻以NEJM ahead-of-print独立确认了这批结果的同步发表(DOI: 10.1056/NEJMoa2608323),与现场帖标注的@NEJM一致;新闻本身只到标题与摘要层面,未补充新的疗效或安全性数字,中位生存、亚组等细节在两边材料中均未披露。
相对已有认识,VOLGA的推进在于:在顺铂不合适或拒绝的人群中,把ADC集中在新辅助阶段、仅3个周期的短程策略即换来EFS与OS双重获益,同时低神经毒性,提示“把ADC用在术前”可能是更优的布局;三药臂的相对失色则提示在此情境下叠加CTLA-4未必获益。局限方面,EVDT臂OS仍为中期分析、数据尚不成熟;pCR与ctDNA清除等读数均来自现场转述,统计学细节、对照组辅助治疗构成与随访时长未披露,最终判断需以NEJM全文为准。
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OncoAlert@OncoAlert Tom Powles@tompowles1 Toni Choueiri, MD@DrChoueiri Karine Tawagi MD@DrKarineTawagi OncoAlert@OncoAlert Tom Powles@tompowles1 Oncology Brothers@OncBrothers 引用@The #ESMO26 Presidential Symposium is about to begin! 🔥 Super excited to hear the highly anticipated results of the VOLGA trial, presented by the the only and only @tompowles1! @myESMO @apolo_andrea @Uromigos @brian_rini @OncoAlert @LosUromigos @uromigosjapan @MichvdHeijden
Yüksel Ürün@DrYukselUrun Karine Tawagi MD@DrKarineTawagi Tian Zhang, MD, MHS, FASCO (@tiansterzhangmd.bsky)@TiansterZhang NEJM@NEJM Petros Grivas@PGrivasMDPhD 引用@Full house for Bladder/RCC updates first with #KN866 #ESMO26 Gem/cis in MIBC + placebo or pembro (➖) study & less relevance in the era of EVP SOC Vs similar trial NIAGARA was ➕ pCR 44.4% vs 35.8% EFS & OS not significant We wait #VOLGA tomorrow for more in this space
Katy Beckermann@katy_beckermann Dr Amol Akhade@SuyogCancer 这些是 THE 曲线。Volga。新的 SOC。@tompowles1 @myESMO #ESMO26 @OncoAlert @OncBrothers。术前使用 3 剂 EV 就足够了。
Yakup Ergün@dr_yakupergun Dra. María Natalia Gandur Quiroga@nataliagandur 引用@🚨 #ESMO26 GU Oncology — Top picks by OncoAlert 🎯 #BladderCancer : VOLGA, KEYNOTE-B15, ENERGIZE, KEYNOTE-866 #ProstateCancer: DASL-HiCaP, CAPItello-281, PROTEUS #KidneyCancer: LITESPARK-011 & -012, ivonescimab, PE-PE, SWOG S2200, XmAb819 Our Participating Faculty @DrChoueiri, @tompowles1, @apolo_andrea, @neerajaiims, @montypal, @Silke_Gillessen, @AOmlin, @brian_rini, @PGrivasMDPhD, @TiansterZhang, @amerseburger , @DrDanielHeng, @HHammersMD, @scocmem, @AndreaNecchi , @AmandaNizamMD, @drenriquegrande, @nataliagandur @AlbigesL, @cdanicas, @declangmurphy, @seanmmcbride, @shilpaonc, @DrRanaMcKay, @scserendipity1, @DrYukselUrun , @ravikanesvaran , @BraunMDPhD, @EfstathiouEleni, @mzugman , @crisbergerot, @ElisaAgostinett, @to_be_elizabeth, @MarioBalsaMD, @BRicciutiMD, @HHorinouchi, @UOzkerim, @p_ciracimd, @DrMirallas , @sonpavde , @Dr_Oncologista
David H Aggen, MD PhD@Dr_Aggen Sara Coca Membribes@scocmem 引用@An OncoAlert #Podium2Screen from the #ESMO26 Presidential Session Presented by our @OncoALert 🚨faculty @tompowles1 Perioperative Durvalumab ± Tremelimumab Plus Neoadjuvant Enfortumab Vedotin in Muscle-Invasive Bladder Cancer: Results From the Phase 3 VOLGA Trial @jteoh_hk @CPRT65 🔬 Phase 3 VOLGA trial (n=695) Evaluated perioperative durvalumab (D) ± tremelimumab (T) plus neoadjuvant enfortumab vedotin (EV) versus control (radical cystectomy [RC], followed by observation or approved adjuvant therapy) in cisplatin-ineligible muscle-invasive bladder cancer (MIBC). Just PUBLISHED in @NEJM https://www.nejm.org/doi/full/10.1056/NEJMoa2608323?referrer=https%3A%2F%2Ft.co%2F Interim analysis; median event-free survival (EFS) follow-up: 22.9 months. ➡️ D + EV: EFS HR 0.51 (95% CI, 0.38–0.67); OS HR 0.58 (95% CI, 0.40–0.83) ➡️ D + T + EV: EFS HR 0.61 (95% CI, 0.47–0.80); OS did not meet statistical significance ➡️ Pathological complete response (pCR): 45% with D + EV vs 10% with control ➡️ Grade 3/4 treatment-related adverse events (TRAEs): 30% with D + EV vs 42% with control ✅ Both primary EFS endpoints were met. Perioperative durvalumab plus 3 cycles of neoadjuvant EV also significantly improved OS. 🎙️ Presenter: Thomas Powles 👥 Investigators: Alexandra Drakaki · Jeremy Teoh · Enrique Grande · Mario Fontes-Sousa · Camillo Porta · Esther Wu · Erik Goluboff · Svetlana Ho · Stephan Hois · Ashok Gupta · James Catto @DrChoueiri @tompowles1 @apolo_andrea @neerajaiims @montypal @Silke_Gillessen @AOmlin @brian_rini @PGrivasMDPhD @TiansterZhang @amerseburger @DrDanielHeng @HHammersMD @scocmem @AndreaNecchi @AmandaNizamMD @drenriquegrande @nataliagandur @AlbigesL @cdanicas @declangmurphy @seanmmcbride @shilpaonc @DrRanaMcKay @scserendipity1 @DrYukselUrun @ravikanesvaran @BraunMDPhD @EfstathiouEleni @mzugman @crisbergerot @niklas_kluemper @Markuseckstein3
OncoAlert@OncoAlert Oriol Mirallas MD@DrMirallas Oncology Brothers@OncBrothers 引用@ESMO 2026 - presidential LBA | VOLGA Phase III – Perioperative Durvalumab + Enfortumab Vedotin (EV) in cisplatin-ineligible/refusing patients: 📊 EV + Durva vs Control • 2-year EFS: 64% vs 45% (HR 0.51; p<0.0001) • 2-year OS: 78% vs 69% (HR 0.58; p=0.0027) • pCR: 45% vs 10% Adding tremelimumab improved EFS (HR 0.61) but no significant OS benefit yet, with higher grade 3/4 toxicity (42% vs 30%). 🔥can this stop the need of post op EV ? Probably yes . New SOC 🙂👍 Looking forward the full datasets @OncBrothers @OncoAlert @myESMO #ESMO26 #VOLGA #BladderCancer
Shilpa Gupta@shilpaonc Karine Tawagi MD@DrKarineTawagi Dra. María Natalia Gandur Quiroga@nataliagandur 引用@🚨⭐ #ESMO26 | GU ONCOLOGY — DAY 2 HIGHLIGHTS A major day for bladder and prostate cancer: practice-relevant phase III data, longer survival follow-up and new molecular clues. 🟠 VOLGA | LBA2 — A pivotal MIBC result In cisplatin-ineligible/refusing MIBC, perioperative durvalumab + neoadjuvant enfortumab vedotin vs radical cystectomy ± approved adjuvant therapy: ✅ 2-year EFS: 64% vs 45% | HR 0.51 ✅ 2-year OS: 78% vs 69% | HR 0.58 A meaningful survival signal, but not a head-to-head comparison with EV + pembrolizumab. 🔵 DASL-HiCaP | LBA4 — Intensification with radiotherapy Darolutamide + ADT + RT improved 4-year metastasis-free survival to 95% vs 88% (HR 0.42) in very-high-risk prostate cancer. OS remains immature; this use is investigational. 🔵 PEACE-1 | 2215O — Durability matters After 7.7 years' follow-up in de novo mCSPC, ADT + docetaxel + abiraterone delivered median OS of 6.2 vs 4.4 years (HR 0.68). Eight-year OS: 40.3% vs 27.1%. 🔵 PROTEUS substudy | LBA53 Perioperative apalutamide + ADT around prostatectomy vs surgery alone in high-risk localised disease: ✅ EFS HR 0.38 (n=408). Promising but setting-specific evidence; longer follow-up matters. 🧬 STAMPEDE / Decipher | 2045O Genomic risk may help identify patients deriving greater benefit from abiraterone for distant-metastasis prevention. Retrospective biomarker evidence—not yet a mandate to de-escalate. 🟠 NIAGARA molecular analysis | 4741RO Exploratory EFS signals across several molecular subtypes, including basal-squamous disease. No validated biomarker yet to withhold perioperative durvalumab. 🟠 EV-103 | 4740RO Long-term EV + pembrolizumab follow-up in advanced urothelial cancer: ✅ Estimated 5-year OS: 33% in pooled cohorts. Durability and late toxicity both matter. 🟠 GDFATHER-NEO | 4757RO Visugromab + nivolumab: ✅ pCR 33.3% vs 7.7% with nivolumab + placebo. Exciting but exploratory (n=28 evaluable). ⭐ MY CLINICAL PEARL Not every form of intensification is equal. What matters is proven survival or metastasis prevention, alongside toxicity, patient selection and quality of life. Precision AND durable benefit—not just higher response rates. @gbanna74 @ravikanesvaran @nataliagandur @neerajaiims @Sebastiano_Buti @CinziaConted @dralishadamani @amg120395 @PGrivasMDPhD @koshkin85 @MicheleMaffezz @ParamMariappan @dmukherji @VanitaNoronha @montypa @DanieleRaggi83 @PasRescigno @jteoh_hk @alison_tree @DrYukselUrun @yekeduz_emre @AgrawalTrush @AndrewKevinAlo1 #ESMO26 #GUOncology #BladderCancer #ProstateCancer #MIBC #mCSPC #PrecisionOncology
Rodrigo Sanchez Roger@RodRogSan Petros Grivas@PGrivasMDPhD 引用@An OncoAlert #Podium2Screen from the #ESMO26 Presidential Session Presented by our @OncoALert 🚨faculty @tompowles1 Perioperative Durvalumab ± Tremelimumab Plus Neoadjuvant Enfortumab Vedotin in Muscle-Invasive Bladder Cancer: Results From the Phase 3 VOLGA Trial @jteoh_hk @CPRT65 🔬 Phase 3 VOLGA trial (n=695) Evaluated perioperative durvalumab (D) ± tremelimumab (T) plus neoadjuvant enfortumab vedotin (EV) versus control (radical cystectomy [RC], followed by observation or approved adjuvant therapy) in cisplatin-ineligible muscle-invasive bladder cancer (MIBC). Just PUBLISHED in @NEJM https://www.nejm.org/doi/full/10.1056/NEJMoa2608323?referrer=https%3A%2F%2Ft.co%2F Interim analysis; median event-free survival (EFS) follow-up: 22.9 months. ➡️ D + EV: EFS HR 0.51 (95% CI, 0.38–0.67); OS HR 0.58 (95% CI, 0.40–0.83) ➡️ D + T + EV: EFS HR 0.61 (95% CI, 0.47–0.80); OS did not meet statistical significance ➡️ Pathological complete response (pCR): 45% with D + EV vs 10% with control ➡️ Grade 3/4 treatment-related adverse events (TRAEs): 30% with D + EV vs 42% with control ✅ Both primary EFS endpoints were met. Perioperative durvalumab plus 3 cycles of neoadjuvant EV also significantly improved OS. 🎙️ Presenter: Thomas Powles 👥 Investigators: Alexandra Drakaki · Jeremy Teoh · Enrique Grande · Mario Fontes-Sousa · Camillo Porta · Esther Wu · Erik Goluboff · Svetlana Ho · Stephan Hois · Ashok Gupta · James Catto @DrChoueiri @tompowles1 @apolo_andrea @neerajaiims @montypal @Silke_Gillessen @AOmlin @brian_rini @PGrivasMDPhD @TiansterZhang @amerseburger @DrDanielHeng @HHammersMD @scocmem @AndreaNecchi @AmandaNizamMD @drenriquegrande @nataliagandur @AlbigesL @cdanicas @declangmurphy @seanmmcbride @shilpaonc @DrRanaMcKay @scserendipity1 @DrYukselUrun @ravikanesvaran @BraunMDPhD @EfstathiouEleni @mzugman @crisbergerot @niklas_kluemper @Markuseckstein3
Martín Angel@Martin_AngelMD KolPulseAI@KolPulseAI UroToday.com@urotoday Maite Bourlon@BourlonMaite