Dr Joaquim Bellmunt speaks to ecancer about the IMvigor011 trial. In this trial, patients with high-risk muscle-invasive bladder cancer who tested positive for circulating tumour DNA (ctDNA) after radical cystectomy were treated with adjuvant atezolizumab or placebo.

Atezolizumab significantly improved disease-free survival (HR 0.64) and overall survival (HR 0.59) compared with placebo, demonstrating the effectiveness of ctDNA-guided immunotherapy in reducing recurrence risk.

Dr Bellmunt says that the patients who remained ctDNA-negative without treatment had excellent outcomes, supporting ctDNA as a tool to personalise adjuvant therapy and avoid overtreatment.