#ASCO26 Provocative PSM data presented evaluating GLP-1 RA exposure in high-risk NMIBC patients receiving BCG: After matching: 🔹 791 GLP-1RA exposed patients 🔹 787 matched controls GLP-1RA exposure was associated with: 🔹 Reduced risk of progression to MIBC →RR 0.43 (p=0.018) 🔹 Reduced all-cause mortality →RR 0.65 (p=0.017) 🔹 No significant differences in NMIBC recurrence, radical cystectomy, or distant metastasis rates. @UroToday @ASCO

#ASCO26 🔬 Abstract 4504 | RAD-IO Durvalumab chemoradiotherapy in muscle-invasive bladder cancer Presented by Nicholas D. James, PhD, MBBS, FRCP @OncoAlert @ASCO Bladder preservation in MIBC remains one of the most important curative-intent questions in GU oncology. The key question here: ➡️ Can immune checkpoint inhibition be safely integrated with standard chemoradiotherapy? RAD-IO evaluated durvalumab with bladder-directed chemoradiotherapy using 5-FU mitomycin C in patients with muscle-invasive bladder cancer. 🧪 Study design Stage 2 efficacy cohort: • T2 N0–2 M0 MIBC • CRT durvalumab • Single-arm phase II design • Primary endpoint: 12-month disease-free survival • 12-month DFS used as a surrogate for longer-term outcome The trial used a clear GO / NO-GO framework: 🟢 GO: DFS ≥75% 🟡 Contextual: 60–75% 🔴 NO-GO: <60% 📌 Feasibility Among 54 participants who started treatment: • 100% received full radiotherapy: 55 Gy in 20 fractions • 0 stopped radiotherapy early • 87% had no RT extension or delay • 100% received mitomycin C • 100% received week 1 5-FU • 78% received week 4 5-FU • 61% completed planned durvalumab • 39% discontinued durvalumab early So, delivery of CRT was highly feasible, while immunotherapy completion was more challenging. 📊 Primary outcome At 12 months post-CRT: • DFS rate: 80% • 40/50 disease-free • 95% CI: 0.67–0.89 This crossed the prespecified GO threshold. Secondary outcome PFS was consistent: • No event: 83.6% • Distant metastasis: 9.1% • Local disease: 7.3% 💬 My take RAD-IO provides an encouraging signal that durvalumab can be integrated with bladder-preserving chemoradiotherapy in MIBC. But this is not yet practice-changing. Important caveats: 🔹 single-arm phase II design 🔹 12-month endpoint 🔹 no randomized comparator 🔹 durability and late toxicity remain critical 🔹 completion of durvalumab was imperfect Still, this is a very relevant direction. In an era where systemic therapy is becoming increasingly active in urothelial cancer, bladder preservation strategies need to evolve too. The next question is not simply whether CRT works. It is: ➡️ Which patients are best suited for bladder preservation? ➡️ Can immunotherapy improve cure without compromising safety? ➡️ How should we integrate systemic therapy, radiation, surgery, and patient preference? For MIBC, the future may be a more personalized curative-intent pathway — not one-size-fits-all cystectomy versus CRT. #ASCO26 #GUOnc #BladderCancer #UrothelialCancer #MIBC #Immunotherapy #RadiationOncology #BladderPreservation

BIG NEWS 📢 The Government has announced up to £18 million in additional funding for TRANSFORM - recognising the crucial role our trial is playing in shaping the future of #ProstateCancer screening. ➡️ Read more: bit.ly/4x9jOVE #MensHealth l #Screening

Since 2012 there's been a 26% decline in the number of care home beds in England per 100 people aged over 75, with a similar drop (23%) seen for nursing home beds. Read our analysis of this indicator of health and care quality: 👉 buff.ly/kS8yTDr #QualityWatch