Study summary

A blood test can show who actually needs chemotherapy after bladder removal

IMvigor011 trial · 761 monitored, 250 randomized, phase 3 · Published October 2025, New England Journal of Medicine

9.9 modisease-free survival with atezolizumab, vs 4.8 months with placebo

What was tested

Serial blood tests for circulating tumor DNA (ctDNA) after bladder removal; people who tested positive were randomized to atezolizumab or placebo, while ctDNA-negative people received no drug at all.

What they found

In ctDNA-positive people, disease-free survival was 9.9 vs 4.8 months and survival was 32.8 vs 21.1 months with atezolizumab.
People who stayed ctDNA-negative did not get the drug and still had excellent outcomes (95% disease-free at 1 year).

What it means

A new model: use a blood test to find who benefits from immunotherapy and spare everyone else the side effects.

N Engl J Med, via PubMed ↗ ← Back to the outlook

Last reviewed 2026-11-14 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.