PADCEV™ Plus KEYTRUDA™, Given Before and After Surgery, Cuts the Risk of Recurrence, Progression or Death by 60% and the Risk of Death by 50% for Certain Patients with Bladder Cancer

Core Insights - Astellas Pharma and Pfizer announced positive results from the Phase 3 EV-303 clinical trial for PADCEV in combination with KEYTRUDA, showing significant improvements in event-free survival (EFS) and overall survival (OS) for muscle-invasive bladder cancer (MIBC) patients who are ineligible for cisplatin-based chemotherapy [1][2][3] Group 1: Clinical Trial Results - The EV-303 trial demonstrated a 60% reduction in the risk of tumor recurrence, progression, or death for patients treated with PADCEV plus KEYTRUDA compared to surgery alone, with a Hazard Ratio (HR) of 0.40 [2] - The estimated median EFS has not yet been reached for the combination arm, while it was 15.7 months for the surgery alone arm [2] - An estimated 74.7% of patients treated with the combination were event-free at two years, compared to 39.4% for surgery only [2] - The OS results showed a 50% reduction in the risk of death for the combination treatment, with an HR of 0.50 [3] - The estimated median OS has not yet been reached for the combination arm, while it was 41.7 months for the surgery arm [3] - An estimated 79.7% of patients were alive at two years in the combination group, compared to 63.1% for surgery alone [3] Group 2: Safety and Efficacy - The safety profile of the combination treatment was consistent with previous reports, with common adverse events including pruritus, alopecia, diarrhea, fatigue, and anemia [5] - Grade 3 adverse events occurred in 71.3% of patients treated with the combination, compared to 45.9% for surgery alone [5] - The pathologic complete response (pCR) rate was 57.1% for the combination treatment versus 8.6% for surgery only, indicating a significant difference [6] Group 3: Implications for Treatment - The results from the EV-303 trial may redefine the standard of care for MIBC patients who are cisplatin-ineligible, offering a new systemic treatment approach that improves survival [7][8] - The trial's findings will be discussed with global health authorities for potential regulatory filings, indicating a pathway for future approval [10] - The combination of PADCEV and KEYTRUDA is currently not approved for neoadjuvant and adjuvant treatment in this patient population, but the results suggest a transformative potential [10][9]