🚨 #ESMO26 | Abstract 4736O | #Podium2Screen
@OncoAlert
Another perioperative MIBC trial reminding us that adding immunotherapy is not automatically the same as improving outcomes.

In phase III CA017-078, presented by @AndreaNecchi 🇮🇹, perioperative nivolumab + gemcitabine/cisplatin was compared with GC alone in muscle-invasive #BladderCancer.

📊 Key results

🔹 EFS: HR 0.94, P=.67 → no significant benefit
🔹 pCR: 39.1% vs 29.6% → numerically higher, but not statistically significant
🔹 OS: still immature
🔹 Grade ≥3 TRAEs: 45.9% vs 49.5%

🎯 Why this matters

The perioperative MIBC landscape is evolving rapidly, but these results reinforce an important principle:

not every checkpoint inhibitor + chemotherapy combination produces the same clinical benefit.

And a higher pCR rate alone is not enough if it does not translate into improved event-free or overall survival.

For me, the next question is biological:

🧬 Can ctDNA/MRD, molecular subtype, or immune biomarkers identify the patients who actually need perioperative intensification — and those who do not?

That may ultimately be more informative than simply adding another drug to everyone.

@AndreaNecchi @shilpaonc @MattGalsky @PGrivasMDPhD @tompowles1 @apolo_andrea @niklas_kluemper @Markuseckstein3 @DrYukselUrun @nataliagandur

#OncoAlert #ESMO26 #MIBC #UrothelialCancer #ctDNA #PrecisionOncology #GUOncology