Dr. Susan Galbraith

induction period with neoadjuvant treatment in the muscle invasive segment, if we could actually get pathologic complete response rates higher, there's an opportunity to save people's bladders in more than one setting.

So I think it's very encouraging progress in general with what we're seeing now.

What does that mean to you?

Yeah, yeah.

Niagara is in the cisplatin eligible population.

So it's a combination of Divalumab plus gemcitabine cisplatin and showed, you know, an improvement in the pathologic complete response rate, but also then that translates through to an improvement in the event-free survival rate.

What you've seen here is in the platinum ineligible population, a further improvement, if you like, in the pathologic complete response rate and a good improvement in event-free survival as well.

So I think what this says, first of all, is it is absolutely possible to further improve the pathologic complete response rates.

We also have an ongoing study, the Volga study, which also looks at a combination of EV, but with the Valumab.

So moving from the Valumab in combination with GEMSYS chemotherapy to the Valumab in combination with an ADC.

And it's also in the cisplatin ineligible population.

The difference between Volga and the study that we've, the Keynote 905 study, is that the EV regimen is just in the neoadjuvant setting.

So there isn't this continued EV dosing in the post-surgical setting.

And I think it'll be interesting to see both the safety profile from that

but also what that means in terms of eventually survival.

Because I think it's very clear that with the tolerability that you get with EEV, not all patients are able to make it through that post-surgical treatment period because of adverse events.

So I think there's an opportunity to differentiate.

That's one difference.

The second difference is that we don't just have a combination arm with divalumab, but we've also got a combination arm with two doses of tremolimumab in that study.

And we know that that treatment regimen with a high level of induction of tremolimumab, if you like, can be well tolerated.