Durvalumab Plus Enfortumab Boosts Bladder Cancer Survival
Perioperative treatment improved survival for cisplatin-ineligible patients with muscle-invasive bladder cancer in the phase 3 VOLGA trial.
Updated on Nov. 4, 2026 in Cancer
Perioperative durvalumab plus neoadjuvant enfortumab vedotin improved survival in cisplatin-ineligible muscle-invasive bladder cancer, according to the phase 3 VOLGA trial presented at the 2026 European Society for Medical Oncology Congress. The trial was designed before the COVID-19 pandemic for patients who historically went directly to cystectomy.
Why it matters
Patients who go directly to cystectomy have historically had worse outcomes than those who receive neoadjuvant therapy, so an effective perioperative regimen addresses a gap for patients unable to receive cisplatin. The results offer a potential treatment option for a subgroup with limited established choices.
The phase 3 VOLGA trial (NCT04960709) enrolled roughly 75% cisplatin-ineligible patients and 25% who declined cisplatin, compared against cystectomy followed by observation. Specific survival hazard ratios and the separate effect of tremelimumab were not reported in the available data.
The players
European Society for Medical Oncology
The European Society for Medical Oncology is a professional society of oncologists that hosts one of the largest annual cancer research congresses in Europe.
The details
One experimental arm gave three cycles of neoadjuvant durvalumab plus enfortumab vedotin before cystectomy, followed by adjuvant durvalumab alone to complete one year. A second arm added tremelimumab, given as three total doses including one adjuvant dose.
Timeline
The VOLGA trial was designed before the COVID-19 pandemic.
Results were presented at the 2026 European Society for Medical Oncology Congress.
Health Landscape
The VOLGA trial extends neoadjuvant immunotherapy strategies to cisplatin-ineligible patients who historically went directly to cystectomy despite poorer outcomes. It shifts the treatment conversation for a population that previously had few established perioperative options.
Patients with muscle-invasive bladder cancer who cannot receive cisplatin may have a new perioperative option to discuss with their oncologist. Treatment decisions depend on individual eligibility and should be made with a care team.
The takeaway
Patients facing muscle-invasive bladder cancer who are not candidates for cisplatin should ask their oncologist whether perioperative immunotherapy trials or regimens are appropriate for them.
Further reading
For broader context on treatment advances, explore our Cancer coverage.
Source note: This article includes information reported by OncLive.
