The Absolute Effect / Evidence / CheckMate 274
Bladder Cancer · Medical Oncology · Adjuvant
CheckMate 274
Clinical question
Does adjuvant nivolumab reduce recurrence after radical surgery for high-risk muscle-invasive urothelial carcinoma?
Trial context
Population
709 patients with high-risk muscle-invasive urothelial carcinoma after radical resection
Intervention
Adjuvant nivolumab vs placebo
Key endpoint
Disease-free survival
Time horizon / follow-up
3-year follow-up
Absolute Effect
What changes for patients?
At 3-year follow-up, median DFS was 22.0 months with nivolumab vs 10.9 months with placebo, HR 0.71. The original trial showed 6-month DFS 74.9% vs 60.3%, an absolute improvement of 14.6 points. A fixed-time NNT is therefore best based on the 6-month DFS landmark: NNT 7. The later median-based difference should not be converted into an NNT.
NNT: 9 for median-event reduction interpretation; fixed-time NNT requires a specified landmark
Treatment burden / harm
Grade ≥3 treatment-related adverse events
NNH: 10
Relative effect
HR: 0.71
95% CI 0.58–0.86
Clinical interpretation
Adjuvant nivolumab improves disease-free survival in selected high-risk postoperative urothelial carcinoma; benefit and eligibility depend on prior neoadjuvant cisplatin and pathological risk.
Primary publication
- Bajorin DF, et al. N Engl J Med. 2021;384:2102–2114.
- Bajorin DF, et al. J Clin Oncol. 2025;43:15–21.
- Primary publication / source
- Primary publication / source