Abstract
Metastatic urothelial carcinoma (UC) remains an aggressive disease with low survival rates. Platinum-based chemotherapy has remained the standard of care in the first-line setting for decades. Data from two randomized phase III studies are considered as a practice-changing options. After the negative results of the KEYNOTE-361 and IMvigor 130 trials, the combination of nivolumab with platinum-based chemotherapy followed by nivolumab maintenance (the CheckMate 901 trial) has demonstrated improvement in both overall survival (OS) and progression-free survival (PFS). The combination of enfortumab vetodin (EV) and pembrolizumab in the first-line setting (the EV-302 study) significantly prolonged PFS and OS in the overall population and in all subgroups. These results support EV and pembrolizumab combination as a new standard in previously untreated locally advanced and metastatic UC.
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