ESMO 2025 | Identifying and managing treatment-related toxicities in the NIAGARA trial
Michiel Van der Heijden, MD, PhD, Netherlands Cancer Institute, Amsterdam, Netherlands, comments on the impact of chemotherapy and durvalumab on patients with muscle-invasive bladder cancer (MIBC). Chemotherapy has the biggest effect on quality of life and toxicity, while the addition of durvalumab does not significantly impact the treatment trajectory. The experimental arm with durvalumab additionally had more patients able to undergo cystectomy compared to the control arm with chemotherapy alone. This interview took place at the European Society for Medical Oncology (ESMO) 2025 Congress in Berlin, Germany.
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Transcript
So for our regimen, which is chemotherapy plus durvalumab, we find that both in toxicities and in health-related quality of life, the chemotherapy portion has the biggest, and the cystectomy of course, but the chemotherapy portion has the biggest impact on quality of life and also toxicity. So of course, with immunotherapy to be mindful of immune-related adverse events so that can happen obviously however what we found is that it did not impact having surgery so actually there were more people in the experimental arm who were able to go on to receive their cystectomy then in the control arm with chemotherapy alone...
So for our regimen, which is chemotherapy plus durvalumab, we find that both in toxicities and in health-related quality of life, the chemotherapy portion has the biggest, and the cystectomy of course, but the chemotherapy portion has the biggest impact on quality of life and also toxicity. So of course, with immunotherapy to be mindful of immune-related adverse events so that can happen obviously however what we found is that it did not impact having surgery so actually there were more people in the experimental arm who were able to go on to receive their cystectomy then in the control arm with chemotherapy alone. So in conclusion we think that the addition of perioperative durvalumab does not impact in any way the whole treatment trajectory for muscle-invasive bladder cancer.
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