# Durvalumab + BCG in BCG-naive high-risk NMIBC

Source: https://onco.cc/pairings/durvalumab-plus-bcg/  
OnCo record `durvalumab-plus-bcg` (Pairing). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Systemic immunotherapy layered on top of bladder BCG reduced recurrence, at the cost of systemic side effects in a disease usually treated locally.

## Summary

Durvalumab given systemically alongside intravesical BCG in BCG-naive high-risk non-muscle-invasive bladder cancer is a combination pairing that reduced recurrence at the cost of systemic side effects in a disease usually treated locally. The rationale is that BCG primes a local Th1 immune response in the bladder, and PD-L1 blockade prevents that response from becoming exhausted while potentially reaching micrometastatic disease. The phase 3 POTOMAC trial was positive for disease-free survival and led to approval in May 2026. The result is not automatically a class effect, because ALBAN, which tested atezolizumab plus BCG, was negative, while CREST, which tested sasanlimab plus BCG, was positive.

## Fields

- Kind: Pairing
- Last checked: 2026-09-07
- Pairs: Durvalumab + Intravesical BCG
- Type: combination
- Rationale: BCG primes a local Th1 response; PD-L1 blockade prevents its exhaustion and may reach micrometastatic disease.
- Evidence: One positive phase 3 (POTOMAC), one negative (ALBAN), one positive with a different agent (CREST).

## Sources

- ClinicalTrials.gov NCT03528694: POTOMAC: https://clinicaltrials.gov/study/NCT03528694

## Connected records

- cancers: [Bladder & urothelial cancer](https://onco.cc/cancers/urothelial/)
- drugs: [Durvalumab](https://onco.cc/drugs/durvalumab/), [Intravesical BCG](https://onco.cc/drugs/bcg-intravesical/)
- trials: [POTOMAC](https://onco.cc/trials/potomac/)

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