Katy Beckermann, Medical Director of GU Clinical Research at Tennessee Oncology, shared a post on LinkedIn:
“Phase III VOLGA results dropped today. High-level press release only, full data not yet published.
Perioperative durvalumab + neoadjuvant EV improved both EFS and OS vs the control arm in cisplatin-ineligible MIBC. The triplet arm (durvalumab + tremelimumab + EV) also met its EFS endpoint and showed a favorable OS trend.
A few things to highlight:
The control arm was not surgery alone. Patients could receive approved adjuvant IO where available. The survival benefit held anyway.
EV in VOLGA is neoadjuvant-only: 3 cycles before surgery, then durvalumab continues without EV adjuvantly. KEYNOTE-905 used 9 total EV cycles across both phases. For a population that often can’t get cisplatin because of renal impairment or comorbidities, less cumulative ADC exposure matters. Neuropathy and skin toxicity accumulate.
Dose reductions happen. The benefit is still there with the shorter course.
The story for this patient population is getting clearer. Surgery alone should not be the default.
Watching for the full data presentation.”
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