Perioperative Imfinzi and Neoadjuvant Chemo Improve Survival in Muscle-Invasive Bladder Cancer

Overview of the NIAGARA Trial Findings

Patients with cisplatin-eligible muscle invasive bladder cancer (MIBC) who received neoadjuvant Imfinzi (durvalumab) in combination with chemotherapy demonstrated substantial improvements in survival compared to those receiving chemotherapy alone. Presented at the 2024 ESMO Congress, the phase 3 NIAGARA study revealed that the median event-free survival (EFS) was not reached in the Imfinzi arm (533 patients) versus 46.1 months in the chemotherapy-only arm (530 patients).

Significant Survival Rates

• At a median follow-up of 42.3 months, the 12- and 24-month EFS rates for the Imfinzi regimen stood at 76% and 67.8%, respectively.
• The comparable rates for the chemotherapy group were 69.9% and 59.8%.
• In patients who completed radical cystectomy, the Imfinzi arm also exhibited outstanding EFS rates of 82.3% at 12 months.

Benefits of the Imfinzi Treatment Regimen

The perioperative Imfinzi regimen reduced the risk of death by 25% compared with the placebo approach. Median overall survival (OS) rates for patients on the Imfinzi treatment were 89.5% and 82.2% at 12 and 24 months, respectively. Moreover, pathologic complete response (pCR) rates showed statistical significance favoring the Imfinzi treatment option, establishing its superiority.

Safety Profile

The addition of perioperative Imfinzi was shown to be tolerable, with manageable side effects. Serious adverse events reported were 62% in the Imfinzi arm against 55% in the comparator group, indicating similar safety profiles across both treatment regimens.