Dr. Andrea Apolo

ongoing right now, and Niagara was the first one to report its outcome. And, you know, once I saw that the Checkmate 901 study was positive, that adding nivolumab actually did improve outcomes to platinum-based chemotherapy, but to cisplatinum-based chemotherapy, it didn't have as strong effect with carboplatinum. So that was...

important because we give cis-platinum-based chemotherapy for patients with muscle-invasive disease in the perioperative setting, neoadjuvant and adjuvant. So that's why I was really excited to hear the results of the Niagara. And of course, we had the press release that it was positive. So really excited to see the results of that trial.

important because we give cis-platinum-based chemotherapy for patients with muscle-invasive disease in the perioperative setting, neoadjuvant and adjuvant. So that's why I was really excited to hear the results of the Niagara. And of course, we had the press release that it was positive. So really excited to see the results of that trial.

important because we give cis-platinum-based chemotherapy for patients with muscle-invasive disease in the perioperative setting, neoadjuvant and adjuvant. So that's why I was really excited to hear the results of the Niagara. And of course, we had the press release that it was positive. So really excited to see the results of that trial.

So great question. And that was one of the things that I really liked about this trial was that it was very practical and real world. And that's what I do in the real world is I go down to 40 and I split the dose. If I can make a patient cis-platinum eligible, I do. And whatever I can do to help the patient become platinum eligible is very important to me, cis-platinum eligible specifically.

So great question. And that was one of the things that I really liked about this trial was that it was very practical and real world. And that's what I do in the real world is I go down to 40 and I split the dose. If I can make a patient cis-platinum eligible, I do. And whatever I can do to help the patient become platinum eligible is very important to me, cis-platinum eligible specifically.

So great question. And that was one of the things that I really liked about this trial was that it was very practical and real world. And that's what I do in the real world is I go down to 40 and I split the dose. If I can make a patient cis-platinum eligible, I do. And whatever I can do to help the patient become platinum eligible is very important to me, cis-platinum eligible specifically.

So I will split the dose of cis-platinum and it's more tolerable. And that's what they did in this trial. And I really like that.

So I will split the dose of cis-platinum and it's more tolerable. And that's what they did in this trial. And I really like that.

So I will split the dose of cis-platinum and it's more tolerable. And that's what they did in this trial. And I really like that.

So great question. I think the standard of care has been the standard of care for a while until we had the approval of nivolumab in the adjuvant setting. And that just happened. It wasn't that long ago. 2021 was when that occurred. And I think that what I would have done differently had I known the activity of nivolumab and the activity of pembrolizumab.

So great question. I think the standard of care has been the standard of care for a while until we had the approval of nivolumab in the adjuvant setting. And that just happened. It wasn't that long ago. 2021 was when that occurred. And I think that what I would have done differently had I known the activity of nivolumab and the activity of pembrolizumab.

So great question. I think the standard of care has been the standard of care for a while until we had the approval of nivolumab in the adjuvant setting. And that just happened. It wasn't that long ago. 2021 was when that occurred. And I think that what I would have done differently had I known the activity of nivolumab and the activity of pembrolizumab.

The ambassador study that I presented at ESMO and I presented the updated 45-month follow-up data. I would have done an adaptive design where if the patients had a pathologic complete response, then maybe we don't need the adjuvant approach. But the truth is we don't really know that, right? Because if we think about this as systemic disease, then maybe they do actually have

The ambassador study that I presented at ESMO and I presented the updated 45-month follow-up data. I would have done an adaptive design where if the patients had a pathologic complete response, then maybe we don't need the adjuvant approach. But the truth is we don't really know that, right? Because if we think about this as systemic disease, then maybe they do actually have

The ambassador study that I presented at ESMO and I presented the updated 45-month follow-up data. I would have done an adaptive design where if the patients had a pathologic complete response, then maybe we don't need the adjuvant approach. But the truth is we don't really know that, right? Because if we think about this as systemic disease, then maybe they do actually have

need a little bit more therapy in the adjuvant setting, even if they achieved a pathologic complete response. But I would have designed it more adaptively. And if the patients didn't respond, I don't think I would have continued adjuvant dervalumab because would there be I don't think there would be a good rationale to continue a therapy that didn't work in the neoadjuvant setting.

need a little bit more therapy in the adjuvant setting, even if they achieved a pathologic complete response. But I would have designed it more adaptively. And if the patients didn't respond, I don't think I would have continued adjuvant dervalumab because would there be I don't think there would be a good rationale to continue a therapy that didn't work in the neoadjuvant setting.

need a little bit more therapy in the adjuvant setting, even if they achieved a pathologic complete response. But I would have designed it more adaptively. And if the patients didn't respond, I don't think I would have continued adjuvant dervalumab because would there be I don't think there would be a good rationale to continue a therapy that didn't work in the neoadjuvant setting.

Now, that's not the way it was designed. Everybody got neoadjuvant in the treatment arm and everybody got adjuvant in the treatment arm. And in the control arm, nobody got adjuvant. But I think that it was a fair design without making it multi-arms. That would have been another way of doing it, but it's already a thousand patients.