Chad Reichard, MD, highlights key takeaways from CREST trial

In a recent interview with Urology Times®, Chad A. Reichard, MD, outlined key findings from the CREST trial (NCT04165317), which is evaluating the combination of sasanlimab plus BCG in patients with high-risk BCG-naïve non–muscle invasive bladder cancer (NMIBC).

Reichard is a urologic oncologist at Urology of Indiana in Indianapolis.

Initial data from the trial read out during a plenary session at the 2025 American Urological Association (AUA) Annual Meeting in Las Vegas, Nevada,¹ marking sasanlimab as the first immunotherapy in combination with BCG to show improved outcomes in this patient population.

In total, the trial enrolled 1055 patients who were randomly assigned 1:1:1 to arm A (sasanlimab plus BCG induction and maintenance), arm B (sasanlimab plus BCG induction), or arm C (BCG induction plus maintenance).

Overall, data showed that the combination of sasanlimab plus BCG (induction and maintenance) significantly improved event-free survival (EFS) vs BCG alone (HR, 0.68; 95% CI, 0.49 to 0.94; 2-sided P = .019). Specifically, the probability of being event-free at 36 months was 82.1% (95% CI, 77.4 to 85.9) in the combination arm vs 74.8% (95% CI, 69.7 to 79.2) in the BCG monotherapy arm. At the time of data report, the median EFS had not been reached.

For the subgroup of patients with carcinoma in situ with or without papillary tumors, the probability of being event free at 36 months was 83.0% in arm A and 71.8% in arm C (HR, 0.53; 95% CI, 0.29 to 0.98).

REFERENCE

1. Shore ND, Powles T, Bedke J, et al. Sasanlimab in combination with Bacillus Calmette-Guérin improves event-free survival versus Bacillus Calmette Guérin as standard of care in high-risk non-muscle invasive bladder cancer: Phase 3 CREST study results. J Urol. 2025;213(5S)