Sasanlimab in combination with bacillus Calmette-Guerin (BCG) in BCG-naive, highrisk non-muscle-invasive bladder cancer (NMIBC): Event-free survival (EFS) subgroup analyses based on disease stage from the CREST study

Abstract

Background: Sasanlimab in combination with BCG (induction [IND] and maintenance [MNT]) significantly improved investigator (INV)-assessed EFS vs BCG (IND and MNT) and had a manageable safety profile in patients (pts) with BCG-naive, high-risk NMIBC, according to the primary analysis results from the phase 3 CREST study. Here, we report exploratory EFS subgroup analyses not previously presented based on disease stage at randomization from Arms A and C. Method(s): Eligible pts were randomized 1:1:1 to receive sasanlimab in combination with BCG (IND and MNT; Arm A), sasanlimab in combination with BCG (IND; Arm B), or BCG (IND andMNT;ArmC). To assess the impact on efficacy of carcinoma in situ (CIS) and T1 tumors at baseline, post hoc INV-assessed EFS analyses were conducted for the comparison of Arm A vs Arm C. EFS was defined as time from randomization to recurrence of high-grade disease, progression of disease, persistence of CIS (for patients with CIS at randomization), or death due to any cause, whichever occurred first. Result(s): At the data cutoff date (Dec 02, 2024), the median duration of follow-up for EFS was 36.4 and 36.7 months for Arm A and Arm C, respectively. A total of 176 pts with CIS (with or without papillary tumors) were in Arms A and C, 102 of whom had CIS without papillary tumors. A total of 398 pts with T1 tumor were in Arms A and C, 342 of whom had T1 tumor without CIS (Table). Three-year landmark EFS subgroup analyses not previously presented are reported in the table. For patients with CIS, with or without concomitant papillary tumors, the 3-year EFS rate was 83.0% in Arm A and 71.8% in Arm C. For patients with T1 tumors, with or without CIS, the 3-year EFS rate was 81.3% in Arm A and 72.2% in Arm C. Conclusion(s): Sasanlimab in combination with BCG (IND and MNT) improved EFS outcomes in the overall population and in the subgroups of pts with BCGnaive, high-risk NMIBC who had CIS or T1 tumors at randomization. This post hoc analysis further supports the potential of sasanlimab in combination with BCG as a practice-changing treatment in pts with aggressive disease.