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Atezolizumab, a monoclonal antibody that inhibits programmed death-ligand 1 (PD-L1), was the first immune checkpoint inhibitor approved by the FDA for advanced urothelial cancer.
Now, investigators have conducted an industry-sponsored, international, randomized, controlled, phase III study (IMvigor211), in which 931 patients with platinum-refractory metastatic urothelial carcinoma received standard-dose atezolizumab or chemotherapy (vinflunine, paclitaxel, or docetaxel). Randomization was stratified by levels of PD-L1 expression, chemotherapy type, presence of liver metastases, and number of risk factors. Median follow-up was 17.3 months.
Among patients with the highest PD-L1 expression (IC2/3), median overall survival (the primary endpoint) …