Network meta-analysis of immune checkpoint inhibitors in BCG-naïve, high-risk non-muscle-invasive bladder cancer.
Joseph McGrath, Indraneel Banerjee, Yudai Ishiyama et al.
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In 30 seconds
This network meta-analysis evaluated the efficacy of immune checkpoint inhibitors (ICIs) combined with BCG in BCG-naïve high-risk non-muscle-invasive bladder cancer (NMIBC). The analysis included phase III trials comparing durvalumab plus BCG and sasanlimab plus BCG against BCG alone. Both durvalumab and sasanlimab significantly improved event-based disease control (HR 0.68; 95% CI 0.50-0.93) compared to BCG alone, while atezolizumab plus BCG did not show significant improvement (HR 0.98; 95% CI 0.71-1.36).
Key findings
- Durvalumab plus BCG and sasanlimab plus BCG significantly improved event-based outcomes compared to BCG alone (HR 0.68 each).
- Atezolizumab plus BCG did not significantly improve outcomes compared to BCG alone (HR 0.98).
- Grade ≥3 treatment-related adverse events were more frequent with ICI plus BCG (21%-29%) than with BCG alone (3.8%-8.8%).
- CIS-stratified analyses indicated durvalumab ranked highest in CIS-absent disease, while sasanlimab ranked highest in CIS-present disease.
Why it matters
The findings highlight the potential of combining immune checkpoint inhibitors with BCG to enhance disease control in high-risk NMIBC, which may influence treatment strategies and patient outcomes in this population.