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Although the introduction of PD-1/PD-LI–targeting immune checkpoint inhibitors represents a major therapeutic development in the management of advanced urothelial cancer (UC), only 20% to 25% of UC patients will derive benefit from these agents. However, advanced UC is endowed with multiple potential therapeutic options, including drugs that target the vascular endothelial growth factor receptors (VEGFR).
To test one such agent in this setting, an international group of investigators conducted an industry-sponsored, randomized, double-blind, phase III study, in which 530 patients with advanced UC received docetaxel (75 mg/m2 every 3 weeks) with or without the IgG1 monoclonal antibody ramucirumab, which binds to VEGFR-2. Most patients had dis…