New bladder cancer option helps people who can’t get cisplatin live longer

If you or someone you love has bladder cancer that has grown into the bladder wall, there is encouraging news. For people who can’t take the usual chemotherapy, a new combination of drugs around surgery helped more of them stay alive.

The usual plan for muscle-invasive bladder cancer is chemotherapy with a drug called cisplatin, then surgery to remove the bladder. But many people can’t take cisplatin, or they choose not to. Until now, they had no proven treatment to add to surgery. This trial changes that.

How the study worked

The VOLGA trial followed people with muscle-invasive bladder cancer who could not or would not take cisplatin. It was a phase 3 trial, the large kind that tests a treatment against the standard approach. Chance decided which of three groups each person joined. It was published on Oct. 24, 2026, in the New England Journal of Medicine. Patients and doctors knew who got which treatment, and the drugmaker AstraZeneca paid for the trial.

• Group 1: durvalumab, an immunotherapy that helps your immune system find cancer, plus enfortumab vedotin, a drug that carries cancer-killing medicine straight to tumor cells. They got these before surgery, then durvalumab after surgery.
• Group 2: the same plan plus a second immunotherapy called tremelimumab.
• Group 3: surgery alone.

What they found

Two years after the study began, more people were alive in the first group. About 78 out of every 100 people were alive with the two-drug plan, compared with about 69 out of every 100 with surgery alone. The exact figures were 78.4% and 69.4%.

More people also stayed free of cancer coming back or getting worse. Event-free survival means being alive with no return or worsening of the cancer. About 64 out of every 100 people in the first group had that result at two years (63.5%). With surgery alone, it was about 45 out of every 100 (45.1%).

The three-drug group did better than surgery alone too. About 60 out of every 100 people were event-free at two years (60.1%).

These drugs do cause side effects. Serious side effects happened in about 71 out of every 100 people in the first group (71.1%). In the three-drug group it was about 80 out of every 100 (79.5%). With surgery alone it was about 50 out of every 100 (50.2%). Your care team can help you manage them.

What you can do today

If you or a loved one has muscle-invasive bladder cancer and can’t take cisplatin, write down one question for the next oncology visit: “Is a treatment with immunotherapy around surgery an option for me?” Bring that question to the appointment.