ESMO 2025 | ctDNA-guided selection for adjuvant immunotherapy in urothelial cancer
Karima Oualla, MD, Hassan II University Hospital, Fes, Morocco, comments on the importance of selecting patients who will benefit most from additional treatments such as nivolumab and pembrolizumab, and highlights the role of biomarkers, including circulating tumor DNA (ctDNA), in identifying these patients. Patients with positive ctDNA seem to derive more benefit from these treatments, which was shown in IMvigor010 trial (NCT02450331), and led to the development of the IMvigor011 trial ((NCT04660344) assessing atezolizumab in ctDNA positive patients. This interview took place at the European Society for Medical Oncology (ESMO) 2025 Congress in Berlin, Germany.
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Transcript
We had nivolumab, pembrolizumab. We have seen also, well, the new adjuvant durvalumab in the NIAGARA trial. But this is a very important question, how to select the patient who will benefit the most from this additional treatment. When we add the treatment, we may add also toxicities. So it’s important to define the subset of patients who will get the most benefit...
We had nivolumab, pembrolizumab. We have seen also, well, the new adjuvant durvalumab in the NIAGARA trial. But this is a very important question, how to select the patient who will benefit the most from this additional treatment. When we add the treatment, we may add also toxicities. So it’s important to define the subset of patients who will get the most benefit. And this is the role of biomarkers. So we have seen in the nivolumab trial and just presented during this ESMO with Dr. Galsky that the patients who are ctDNA positive seem to have more benefit from nivolumab than the ones who are ctDNA negative because ctDNA is really a highly prognostic biomarker. We had also the same observation before from the IMvigor trial, IMvigor010. It was a negative trial for adjuvant atezolizumab. But when we go and look for the biomarkers, we found that the ctDNA positive patients get benefit from the adjuvant atezolizumab, which led to the trial IMvigor011 that assesses atezolizumab only in this population with ctDNA positive disease. And the results will be on this Monday during the ESMO.
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