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NCT Number: NCT06960577

Perioperative Durvalumab With Neoadjuvant ddMVAC or Gemcitabine/Cisplatin in Patients With Muscle-invasive Bladder Cancer (NIAGARA-2)

The Phase IIIb NIAGARA-2 study aims to expand on the data from the Phase III NIAGARA study by investigating perioperative durvalumab in combination with investigator-selected cisplatin-based neoadjuvant chemotherapy (either ddMVAC or gemcitabine/cisplatin) in a clinical practice setting.

Recruiting

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 3

Primary location

Research Site, Chermside, Australia

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About this study

Not provided

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Participants with clinical tumour stage T2-T4aN0/1M0 or T1N1M0 with transitional or mixed transitional cell histology
  • Patients must be planning to undergo radical cystectomy
  • Patients who have not received prior systemic chemotherapy or immunotherapy for treatment of muscle-invasive bladder cancer
  • ECOG performance status of 0 or 1
  • Minimum life expectancy of 12 weeks at first dose of study medication

Exclusion criteria

  • Evidence of lymph node (N2-N3) or metastatic (M1) disease
  • Inoperable tumour(s) with fixation to the pelvic wall on clinical examination
  • Prior exposure to immune-mediated therapy including, but not limited to, other anti CTLA-4, anti-PD 1, anti-PD L1 and anti-PD-L2 antibodies, excluding Bacillus Calmette-Guérin
  • Current or prior use of immunosuppressive medication within 14 days before the first dose of durvalumab
  • Any concomitant medication known to be contraindicated to the chemotherapy (ddMVAC or gem/cis).
  • Uncontrolled intercurrent illness.

Treatment and study plan

Durvalumab

Drug

Anti- PD-L1 Antibody.

methotrexate

Drug

Chemotherapy agent.

Vinblastine

Drug

Chemotherapy agent

Doxorubicin

Drug

Chemotherapy agent

Cisplatin

Drug

Chemotherapy agent

Gemcitabine

Drug

Chemotherapy agent

Primary outcomes

  1. The safety of neoadjuvant durvalumab combined with ddMVAC or gem/cis prior to radical cystectomy (RC).

    Time frame: Up to 6 months

    Incidence of Grade 3 or 4 [possibly treatment-related adverse events (PRAEs)] as observed prior to RC.

Secondary outcomes

  1. The safety and tolerability of perioperative durvalumab combined with ddMVAC or gem/cis.

    Time frame: Up to 2 years

    Incidence, severity, nature, seriousness, intervention/treatment, outcome, and causality of treatment-emergent adverse events, including PRAEs, adverse events of special interest, immune-mediated adverse events, adverse events (AEs), and serious adverse events; AEs resulting in study treatment interruption and discontinuation; laboratory findings.

  2. The efficacy of perioperative durvalumab combined with ddMVAC or gem/cis in terms of event-free survival (EFS).

    Time frame: Up to 3 years

    EFS is defined as the time from first neoadjuvant durvalumab + chemotherapy treatment until the earliest occurrence of any of the following events:

    • First recurrence of disease after RC
    • First documented progression in participants who were medically precluded from RC
    • Time of expected surgery in participants who refuse to undergo RC or failure to undergo RC in participants with residual disease
    • Death due to any cause.
  3. The efficacy of perioperative durvalumab combined with ddMVAC or gem/cis in terms of disease-free survival (DFS).

    Time frame: Up to 3 years

    DFS is defined as the time from the date of RC to the earliest of the first recurrence of disease post RC or death due to any cause.

  4. The efficacy of perioperative durvalumab combined with ddMVAC or gem/cis in terms of OS.

    Time frame: Up to 3 years

    OS is defined as the time from first neoadjuvant durvalumab + chemotherapy until death due to any cause.

  5. The efficacy of neoadjuvant durvalumab combined with ddMVAC or gem/cis followed by RC in terms of pathologic complete response (pCR).

    Time frame: Up to 3 years

    pCR rate is defined as the proportion of participants whose pathologic staging is T0N0M0 as assessed per local pathology review using specimens obtained via RC.

  6. The efficacy of neoadjuvant durvalumab combined with ddMVAC or gem/cis followed by RC in terms of pathologic downstaging (pDS).

    Time frame: Up to 3 years

    pDS rate is defined as the proportion of participants whose pathologic staging is <P2 per local pathology review using specimens obtained via RC.

Study contacts

Contact information is provided by the study sponsor or research team.

AstraZeneca Clinical Study Information Center

CONTACT

[email protected]

1-877-240-9479

Sponsors and collaborators

Lead sponsor

AstraZeneca

Industry

Registry information

Official study title

A Phase IIIb, Open-label, Single-arm, Global Study of Perioperative Durvalumab With Neoadjuvant ddMVAC or Gem/Cis in Patients With Muscle-invasive Bladder Cancer (NIAGARA-2)

Important dates

Study start
2025
Primary completion
2028
Study completion
2028
First posted
May 7, 2025
Registry last updated
Jun 11, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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