SWOG S1605
Does systemic atezolizumab provide sufficient durable response in BCG-unresponsive high-risk NMIBC to support bladder preservation?
Key reported outcomes
Values are reproduced from the linked sources. Bars are a visual aid and are scaled within each outcome row; do not compare bar lengths across different endpoints.
27%
49%
16%
Among 74 patients with CIS, 20 (27%) achieved complete response at 6 months. In Ta/T1 disease, 18-month EFS was 49%. Grade 3–5 treatment-related adverse events occurred in 16%, including three treatment-related deaths.
Critical appraisal
The prespecified efficacy threshold was not met; the study had small cohorts and substantial ineligibility. The toxicity and progression risks weigh heavily when comparing systemic immunotherapy with cystectomy or approved bladder-preserving approaches.
Absolute-effect discipline: NNT/NNH is not calculated unless a defensible absolute difference and a common time horizon are available. Median survival differences and hazard ratios alone are not converted into NNT.
Current-practice context
Reviewed 2026-10-14; this is a dated evidence-context note, not a substitute for local guidelines or individual clinical judgement.
Investigational/historical evidence; atezolizumab is not an approved standard treatment for BCG-unresponsive NMIBC. Use the page to understand the limits of checkpoint blockade in this setting, not as a treatment recommendation.
Freshness status: this page has a dated context and source links, but is not a claim that every relevant guideline or subsequent publication has been exhaustively reviewed.