Prof Powles talks to ecancer at ESMO 2025 about data he presented from the phase III IMvigor011 trial.

This evaluated a circulating tumour DNA (ctDNA)-guided approach to adjuvant therapy in patients with high-risk muscle-invasive bladder cancer (MIBC) after cystectomy. 

Among 761 participants enrolled in ctDNA surveillance, 250 ctDNA-positive patients were randomized to atezolizumab or placebo. At a median follow-up of 16.1 months, atezolizumab significantly improved disease-free survival (HR 0.64; P = 0.0047) and overall survival (HR 0.59; P = 0.0131) versus placebo, with a manageable safety profile. 

Patients who remained ctDNA-negative had good outcomes without adjuvant therapy (2-year DFS = 88.4%), supporting ctDNA as a biomarker to individualize post-surgical treatment in MIBC.