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Which patients with muscle invasive bladder cancer will you treat with adjuvant nivolumab?

How do prior chemotherapy, site of disease, and pathological staging inform your decision? How about molecular markers (PD-L1, ctDNA)?
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Which patients with MIBC would you offer adjuvant nivolumab to?

146 physicians have voted

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5 Answers
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Medical Oncology · AdventHealth Cancer Institute
Answered on

I treat patients who fulfill the eligibility criteria of CheckMate 274. Thus, patients must have had radical surgery (R0, with negative surgical margins) within 120 days before randomization, with or without neoadjuvant cisplatin-based chemotherapy. Patients must have had pathological evidence of ur...

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Medical Oncology · University of North Carolina at Chapel Hill
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I would discuss the use of adjuvant nivolumab in the patient population with high risk MIBC that were included in the CM274 study. The improvement in DFS was seen in the ITT population (HR 0.70) and the PD-L1 + population (HR 0.55). Although the DFS is more pronounced in the PD-L1+ group, I do not t...

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Medical Oncology · University Of Kansas Hospital Authority
Answered on

At present, we are still functioning without the information we need for risk-adapted decision-making about adjuvant Nivolumab. Patients with high volume residual disease, particularly nodal disease, following neoadjuvant chemotherapy are at high risk for recurrence, metastasis, and death from bladd...

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Medical Oncology · Icahn School of Medicine at Mount Sinai
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Adjuvant nivolumab should be considered for patients with urothelial cancer at high risk for recurrence after curative intent surgery which, as per the eligibility for CM274, included patients with >/= pT3 and/or pN+ who are cisplatin ineligible or decline adjuvant cisplatin-based chemotherapy or pa...

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Medical Oncology · University of North Carolina at Chapel Hill
Answered on

Based on the updated survival data presented at ASCO GU 2025, I am considering adjuvant nivolumab for patients who meet the eligibility criteria of CheckMate 274. In the CheckMate 274 trial, patients with ypT2-ypT4a disease or ypN+ muscle invasive urothelial carcinoma (MIUC) after receiving neoadjuv...

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