Joshua Meeks

Key Points
  • Subgroup analysis from the NIAGARA trial showed survival benefits with durvalumab plus chemotherapy in patients with muscle-invasive bladder cancer (MIBC).

  • Disease-free survival benefits observed across subgroups, including both pathological complete response (pCR) and non-pCR cohorts.

  • Comparison of the NIAGARA versus VESPER clinical trial outcomes and how they influence MIBC treatment.

The groundbreaking NIAGARA trial has produced significant findings in muscle-invasive bladder cancer (MIBC) that has reshaped the treatment paradigm.

The addition of perioperative durvalumab to neoadjuvant chemotherapy and radical cystectomy improved disease-free survival (DFS) in patients, further reinforcing durvalumab’s role in bladder cancer treatment. DFS serves not only as a meaningful clinical endpoint but also as a valuable tool for oncologists to communicate the benefits of therapy to patients.

During a featured roundtable discussion at the 2025 American Society of Clinical Oncology Annual Meeting, Joshua Meeks, MD, PhD, of Northwestern Medicine, Chicago, Illinois, along with the Oncology Brothers, reviewed updated subgroup analysis findings of the NIAGARA trial. The discussion highlighted DFS and event-free survival outcomes, as well as insights into response patterns in both pathological complete response (pCR) and non-pCR groups.

Dr. Meeks also offered a comparative perspective of the NIAGARA and VESPER trials.