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Platinum-based chemotherapy has long been the standard of care for metastatic urothelial cancer, with cisplatin eligibility determined based on clinical and laboratory features. Recently, both pembrolizumab, a PD-1 inhibitor, and enfortumab vedotin, an antibody–drug conjugate directed against nectin-4, demonstrated improved overall survival (OS) compared with a variety of chemotherapeutic agents in phase 3 studies, and the combination of enfortumab vedotin and pembrolizumab (EVP) demonstrated provocative antitumor activity in a phase 2 study. Now, in an industry-funded, global, phase 3, randomized trial, investigators compared platinum-based chemotherapy (gemcitabine plus cisplatin or carboplatin) against EVP.
Eligible patients had unresecta…