New Reference: Adjuvant Nivolumab for Muscle-Invasive Bladder Cancer

The study found that adjuvant nivolumab significantly improved disease-free survival compared to placebo in patients with high-risk muscle-invasive urothelial carcinoma. The analysis also identified circulating tumor DNA as a potential biomarker for recurrence risk, with undetectable ctDNA levels indicating a better prognosis.

  • Study

    Phase III randomized, double-blind, multicenter study [CheckMate 274]
    Patients with high-risk muscle-invasive urothelial carcinoma after radical surgery
    Nivolumab (n=353) vs placebo (n=356), every 2 weeks for up to 1 year



  • Efficacy

    Median DFS: 21.9 mos vs 11.0 mos (nivolumab vs. placebo) (HR 0.74 [0.61-0.90])
    Median OS: 75.0 mos vs 50.1 mos (HR 0.83 [0.67-1.02])
    Patients with PD-L1 >=1%:
    Median DFS 55.5 mos vs 8.4 mos (HR 0.58 [0.42-0.79])
    Median OS: NR vs. 59.4 mos (HR: 0.63 [0.44-0.90])



  • Safety

    No new safety signals reported.
    Common treatment-related AEs included pruritus, fatigue, and diarrhea.


  • J Clin Oncol. Published online 17 October 2025

    Galsky MD, Gschwend JE, Milowsky MI Adjuvant nivolumab versus placebo for high-risk muscle-invasive urothelial carcinoma: 5-year efficacy and ctDNA results from CheckMate 274

    http://doi.org/10.1016/j.annonc.2025.09.139

    Reviewed by Ulas D. Bayraktar, MD on Jan 21, 2026

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