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NCT03924895 · OUTCOME

Pathologic Complete Response (pCR) Rate Between Arm C and Arm B

Perioperative Pembrolizumab (MK-3475) Plus Cystectomy or Perioperative Pembrolizumab Plus Enfortumab Vedotin Plus Cystectomy Versus Cystectomy Alone in Participants Who Are Cisplatin-ineligible or Decline Cisplatin With Muscle-invasive Bladder Cancer (MK-3475-905/KEYNOTE-905/EV-303) · Source last updated 2026-06-30

Results reported by the registry submitting party. Population, time horizon, units and missing values must be read together.

Measure
NUMBER
Unit
Percentage of Participants
Interval / dispersion
95% Confidence Interval
Time frame
Up to approximately 53 monhts

What was measured

Pathologic complete response rate is defined as the percentage of participants having pCR. pCR is defined as absence of viable tumor (pT0N0) in examined tissue from RC and PLND, as assessed by blind independent central review (BICR).

Analysis population: Participants were randomized in two stages. Stage 1 assigned participants 1:1 to Arm A (pembrolizumab plus surgery) or Arm B (surgery alone). Stage 2 added Arm C (enfortumab vedotin plus pembrolizumab and surgery), and participants were randomized 1:1:1 to Arms A, B, and C. The analysis population included all participants randomized in Stage 2 to Arm C or Arm B, regardless of treatment received. Participants were analyzed according to randomized arm.

Groups in this outcome

Arm A: Pembrolizumab + Surgery

Participants receive 3 preoperative cycles of pembrolizumab, followed by standard of care surgery, followed by 14 cycles of postoperative pembrolizumab. Each cycle is 21 days.

Arm B: Surgery Alone

Participants receive standard of care surgery alone.

Arm C: Enfortumab Vedotin + Pembrolizumab + Surgery

Participants receive 3 preoperative cycles of enfortumab vedotin + pembrolizumab, followed by standard of care surgery, followed by 6 cycles of postoperative enfortumab vedotin + pembrolizumab, followed by 8 cycles of pembrolizumab alone. Each cycle is 21 days.

Group identifiers and denominators belong to this outcome only. They may differ in another outcome or in safety reporting.

Analysis denominator · Participants

GroupSource count
Arm A: Pembrolizumab + Surgery0
Arm B: Surgery Alone174
Arm C: Enfortumab Vedotin + Pembrolizumab + Surgery170

Reported measurements

Source class 1
Values in Percentage of Participants · Interval/dispersion: 95% Confidence Interval
GroupValueSpreadLowerUpperComment
Arm B: Surgery Alone8.6Not reported4.913.8Not reported
Arm C: Enfortumab Vedotin + Pembrolizumab + Surgery57.1Not reported49.364.6Not reported

Source statistical analyses

Group order, estimate direction, methods and comments are retained. No treatment ranking is inferred.

  1. ci Lower Limit
    39.5
    ci Num Sides
    TWO_SIDED
    ci Pct Value
    95
    ci Upper Limit
    56.5
    estimate Comment
    Arm C: EV+ Pembrolizumab +Surgery vs Arm B: Surgery Alone
    group Description
    Based on Miettinen \& Nurminen method stratified by cisplatin status (cisplatin-ineligible vs cisplatin-eligible but declined), tumor stage (T2N0 vs T3/T4aN0 vs T1-4aN1), and geographic regions (US vs EU vs MOW) with small strata collapsed
    group Ids
    1. OG001
    2. OG002
    non Inferiority Type
    SUPERIORITY
    p Value
    <0.000001
    param Type
    Difference in Percentage
    param Value
    48.3
    statistical Method
    Miettinen & Nurminen method
Complete source fields
analyses
  1. ci Lower Limit
    39.5
    ci Num Sides
    TWO_SIDED
    ci Pct Value
    95
    ci Upper Limit
    56.5
    estimate Comment
    Arm C: EV+ Pembrolizumab +Surgery vs Arm B: Surgery Alone
    group Description
    Based on Miettinen \& Nurminen method stratified by cisplatin status (cisplatin-ineligible vs cisplatin-eligible but declined), tumor stage (T2N0 vs T3/T4aN0 vs T1-4aN1), and geographic regions (US vs EU vs MOW) with small strata collapsed
    group Ids
    1. OG001
    2. OG002
    non Inferiority Type
    SUPERIORITY
    p Value
    <0.000001
    param Type
    Difference in Percentage
    param Value
    48.3
    statistical Method
    Miettinen & Nurminen method
classes
  1. categories
    1. measurements
      1. group Id
        OG001
        lower Limit
        4.9
        upper Limit
        13.8
        value
        8.6
      2. group Id
        OG002
        lower Limit
        49.3
        upper Limit
        64.6
        value
        57.1
denoms
  1. counts
    1. group Id
      OG000
      value
      0
    2. group Id
      OG001
      value
      174
    3. group Id
      OG002
      value
      170
    units
    Participants
description
Pathologic complete response rate is defined as the percentage of participants having pCR. pCR is defined as absence of viable tumor (pT0N0) in examined tissue from RC and PLND, as assessed by blind independent central review (BICR).
dispersion Type
95% Confidence Interval
groups
  1. description
    Participants receive 3 preoperative cycles of pembrolizumab, followed by standard of care surgery, followed by 14 cycles of postoperative pembrolizumab. Each cycle is 21 days.
    id
    OG000
    title
    Arm A: Pembrolizumab + Surgery
  2. description
    Participants receive standard of care surgery alone.
    id
    OG001
    title
    Arm B: Surgery Alone
  3. description
    Participants receive 3 preoperative cycles of enfortumab vedotin + pembrolizumab, followed by standard of care surgery, followed by 6 cycles of postoperative enfortumab vedotin + pembrolizumab, followed by 8 cycles of pembrolizumab alone. Each cycle is 21 days.
    id
    OG002
    title
    Arm C: Enfortumab Vedotin + Pembrolizumab + Surgery
param Type
NUMBER
population Description
Participants were randomized in two stages. Stage 1 assigned participants 1:1 to Arm A (pembrolizumab plus surgery) or Arm B (surgery alone). Stage 2 added Arm C (enfortumab vedotin plus pembrolizumab and surgery), and participants were randomized 1:1:1 to Arms A, B, and C. The analysis population included all participants randomized in Stage 2 to Arm C or Arm B, regardless of treatment received. Participants were analyzed according to randomized arm.
reporting Status
POSTED
time Frame
Up to approximately 53 monhts
title
Pathologic Complete Response (pCR) Rate Between Arm C and Arm B
type
SECONDARY
unit Of Measure
Percentage of Participants

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Preserved source evidence · Not medical advice