New Drug Combination Boosts Survival in Bladder Cancer Trial

Results from the VOLGA trial, presented at the European Society for Medical Oncology (ESMO) annual congress and published simultaneously in the New England Journal of Medicine, show that patients who received durvalumab before and after surgery, plus enfortumab vedotin before surgery, had an event-free survival rate of 63.5% at 24 months. Among patients who had surgery alone, that figure was 45.1%.

Muscle-invasive bladder cancer — a form of the disease in which tumour cells have grown into the muscle wall of the bladder — carries a higher risk of the cancer spreading and is typically treated with surgical removal of the bladder. The trial tested whether adding immunotherapy before and after that operation, and an antibody-drug therapy before it, could improve outcomes.

The 18-percentage-point difference in event-free survival at two years is the headline finding. Event-free survival measures the proportion of patients still alive without their cancer returning, spreading, or requiring additional treatment within the study period.

Durvalumab is a type of immunotherapy that helps the body’s immune system identify and attack cancer cells. Enfortumab vedotin is an antibody-drug conjugate — essentially a targeted delivery system that carries a toxic payload directly to cancer cells while sparing healthy tissue. Durvalumab was given both before and after the operation (perioperatively); enfortumab vedotin was given before it (neoadjuvantly).

The trial results were reported by the New England Journal of Medicine. Full peer-reviewed data are available through the journal.

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Patients with questions about bladder cancer treatment or clinical trials should speak to their GP or hospital specialist. General health queries can be directed to NHS 111 (call 111 or use the online service). In a medical emergency, call 999.