Abstract
Vinflunine is the only agent that has been developed and registered in the treatment of metastatic urothelial carcinoma after the failure of a platinum-containing regimen. It was registered in 2009 as single agent on the basis of a phase III pivotal trial that followed two phase II trials. The results of the phase III trial were confirmed in a long-term analysis and in subgroup analyses. Vinflunine is now recommended in European guidelines. Its usage can be adapted to special populations that are not rare in this disease, such as elderly patients or patients with renal or hepatic impairment. However, there remain some unmet medical needs that further development with vinflunine could theoritically meet in order to further improve the care of patients with urothelial carcinoma. Several tracks are being explored, which include first-line or maintenance chemotherapy regimens for patients who are not fit for cisplatin.
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