You begin the study treatment after joining the trial. The treatment includes durvalumab, which is given by intravenous infusion (through a vein), and ddMVAC, which is cisplatin-based chemotherapy.

The study is designed to give durvalumab together with ddMVAC before radical cystectomy (RC), which is surgery to remove the bladder.

You receive durvalumab 1500 mg by intravenous infusion. The product used is IMFINZI 50 mg/mL concentrate for solution for infusion.

You also receive ddMVAC chemotherapy before surgery. The source data do not give the exact dose, frequency, or duration of ddMVAC, but it is given as part of the pre-surgery treatment period.

During this stage, your health is monitored for side effects. The study checks for side effects that are considered possibly related to the study treatment, including serious side effects and changes in laboratory test results.

Before radical cystectomy (RC), the study measures whether you have any grade 3 or 4 treatment-related side effects. Grade 3 or 4 means severe or very severe side effects.

The study also checks for side effects that may lead to treatment interruption or stopping treatment.

After the pre-surgery treatment period, you undergo radical cystectomy (RC) if surgery is performed.

The study uses tissue from this surgery to assess the response to treatment.

After RC, the study reviews the surgical tissue to determine whether there is any remaining cancer.

The main tissue-based outcome is whether the result is T0N0M0, which means no sign of tumor in the bladder tissue, no spread to nearby lymph nodes, and no spread to distant sites.

The study also checks whether the result is less than P2, which means the cancer stage in the tissue is below a certain level.

After treatment and surgery, the study follows your progress over time to look for cancer returning, disease getting worse, or death from any cause.

The study measures event-free survival (EFS), which is the time from the first durvalumab + ddMVAC treatment until the first of these events: cancer returns after RC, disease gets worse if surgery cannot be done for medical reasons, or surgery does not happen when expected or when there is remaining disease.

The study measures disease-free survival (DFS) from the date of RC until the cancer returns after surgery or death from any cause.

The study measures overall survival (OS) from the first durvalumab + ddMVAC treatment until death from any cause.