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Cisplatin-based chemotherapy remains the only treatment known to offer the potential for cure in advanced urothelial cancer, albeit in only a small subset of patients. PD-L1 and PD-1 inhibitors have demonstrated significant activity as both first- and second-line immunotherapies in this setting, but in only a modest subset of patients.
Now, investigators have conducted an industry-supported, international, randomized, phase III trial (IMvigor130) in which 1213 untreated patients (24.5% women; mean age, 68 years) with advanced urothelial cancer were assigned to receive one of three treatments: the PD-L1 inhibitor atezolizumab plus platinum-based chemotherapy (cisplatin or carboplatin), atezolizumab alone, or chemotherapy alone. The coprimary …