Chemo-Immunotherapy in Advanced Urothelial Cancer

Platinum-based multi-agent chemotherapy has been the standard of care for metastatic urothelial cancer for 40 years, with level 1 evidence supporting the use of cisplatin-based combination therapy. Two previous phase 3 studies testing immune checkpoint blockade in combination with either cisplatin- or carboplatin-based chemotherapy failed to demonstrate improvement in overall survival (OS).

Now, in a pharmaceutical-sponsored, multinational, open-label, phase 3 trial, investigators randomized patients with previously untreated metastatic urothelial cancer to receive either gemcitabine-cisplatin (GC) alone (every 3 weeks for 6 cycles) or GC plus nivolumab (every 3 weeks for 6 cycles followed by nivolumab every 4 weeks) until disease progressio…