#ESMO26 VOLGA: Could just 3 cycles of neoadjuvant EV redefine treatment for cisplatin-ineligible MIBC?
@tompowles1 presented landmark phase III results:

🔹 EV + durvalumab doublet: EFS HR 0.51; OS HR 0.58 (42% lower risk of death)
🔹 pCR: 45% vs 10% with surgery alone
🔹 Triplet (+ tremelimumab): EFS HR 0.61; OS not yet significant
🔹 ctDNA: ~78% positive at baseline; ~60% clearance by postsurgery assessment.
🔹 Safety: Grade 3–4 AEs ~30% with the doublet, only 11% interruption of EV

🚨The big message: Just 3 neoadjuvant cycles of EV + durvalumab, followed by cystectomy and adjuvant durvalumab alone, deliver a substantial survival benefit.

A new standard for cisplatin-ineligible MIBC?
🚨Concomitant publication @NEJM
@UroToday @myESMO