OnCo
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POTOMAC

Adding a year of durvalumab to standard BCG bladder instillations cut the risk of recurrence or progression by about a third, the first systemic immunotherapy approved in early bladder cancer.

DFS HR 0.68 (95% CI 0.50-0.93). FDA approval 28 May 2026. The first checkpoint inhibitor in BCG-naive NMIBC; raises questions of overtreatment given BCG's long-term success in many patients and adds systemic toxicity to a bladder-only disease.

Setting
BCG-naive high-risk non-muscle-invasive bladder cancer: durvalumab + BCG (induction and maintenance) vs BCG
Phase
Phase 3
Sponsor
AstraZeneca
Registry
Headline result
DFS HR 0.68.
Reported
2025
Enrolled
1018
Replication
KEYNOTE-676 (pembrolizumab + BCG) and CREST (sasanlimab + BCG, positive 2025) test the same concept; ALBAN (atezolizumab + BCG) was negative.

Outcomes

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In plain words
What these results mean for people, not percentages
1,018 people took part
Disease-free survivalprimarysurrogate endpoint
  • The treated group had about 32 percent lower chance of the event at any given time (hazard ratio 0.68).
  • The absolute difference, how many more people out of 100 were helped, is not reported here.
  • This is a surrogate endpoint: it measures the cancer being controlled or absent on scans and tests, which often, but not always, translates into living longer.
  • These results apply to the people the trial enrolled: BCG-naive high-risk non-muscle-invasive bladder cancer: durvalumab + BCG (induction and maintenance) vs BCG. People in a different situation may not see the same effect.

Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.

1,018 participants enrolled.

Disease-free survivalprimary
HR 0.68 (0.5–0.93) · p = 0.0154

Numbers not yet public.

Source
EndpointArmnValueHR (95% CI)pSource
Disease-free survivalprimaryDurvalumab + BCG (induction + maintenance)0.68 (0.5–0.93)0.0154link
BCG (induction + maintenance)
Replication
KEYNOTE-676 (pembrolizumab + BCG) and CREST (sasanlimab + BCG, positive 2025) test the same concept; ALBAN (atezolizumab + BCG) was negative.

Connected

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