Durable responses with first-line platinum-based chemotherapy for advanced-stage urothelial carcinoma are rare, and patient outcomes are poor. Recently, CheckMate 901 became the first phase III trial to establish a significant overall survival benefit from a combined chemoimmunotherapy approach in this disease setting. Herein, we discuss key findings from CheckMate 901 and their implications in the context of a rapidly evolving treatment landscape.
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References
von der Maase, H. et al. Long-term survival results of a randomized trial comparing gemcitabine plus cisplatin, with methotrexate, vinblastine, doxorubicin, plus cisplatin in patients with bladder cancer. J. Clin. Oncol. 23, 4602–4608 (2005).
De Santis, M. et al. Randomized phase II/III trial assessing gemcitabine/carboplatin and methotrexate/carboplatin/vinblastine in patients with advanced urothelial cancer who are unfit for cisplatin-based chemotherapy: EORTC study 30986. J. Clin. Oncol. 30, 191–199 (2012).
Powles, T. et al. Avelumab maintenance therapy for advanced or metastatic urothelial carcinoma. N. Engl. J. Med. 383, 1218–1230 (2020).
Bellmunt, J. et al. Pembrolizumab as second-line therapy for advanced urothelial carcinoma. N. Engl. J. Med. 376, 1015–1026 (2017).
Galsky, M. D. et al. Atezolizumab with or without chemotherapy in metastatic urothelial cancer (IMvigor130): a multicentre, randomised, placebo-controlled phase 3 trial. Lancet 395, 1547–1557 (2020).
Powles, T. et al. Pembrolizumab alone or combined with chemotherapy versus chemotherapy as first-line therapy for advanced urothelial carcinoma (KEYNOTE-361): a randomised, open-label, phase 3 trial. Lancet Oncol. 22, 931–945 (2021).
Galsky, M. D. et al. 658MO - Cisplatin (cis)-related immunomodulation and efficacy with atezolizumab (atezo) + cis- vs carboplatin (carbo)-based chemotherapy (chemo) in metastatic urothelial cancer (mUC). Ann. Oncol. 32 (Suppl. 5), S682–S683 (2021).
van der Heijden, M. S. et al. Nivolumab plus gemcitabine-cisplatin in advanced urothelial carcinoma. N. Engl. J. Med. 389, 1778–1789 (2023).
Powles, T. B. et al. LBA6 EV-302/KEYNOTE-A39: Open-label, randomized phase III study of enfortumab vedotin in combination with pembrolizumab (EV+P) vs chemotherapy (Chemo) in previously untreated locally advanced metastatic urothelial carcinoma (la/mUC). Ann. Oncol. 34 (Suppl. 2), S1340 (2023).
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N.A. declares grants (to her institution) from AstraZeneca and EMD Serono, and consulting and/or advisory roles for AstraZeneca, Bayer, Bristol Myers Squibb, EMD Serono, Gilead, Janssen, Merck, Pfizer and Seagen. S.S.S. declares research funding (to her institution) from EMD Serono, Janssen and Seagen, and consulting and/or advisory roles for Astellas, AstraZeneca, Bayer, Bicycle Therapeutics, Bristol Myers Squibb, Eisai, EMD Serono, Gilead, Ipsen, Janssen, Merck, Pfizer and Seagen.
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Alimohamed, N., Sridhar, S.S. Combination strategies for advanced-stage urothelial carcinoma: a paradigm shift. Nat Rev Clin Oncol 21, 255–256 (2024). https://doi.org/10.1038/s41571-024-00861-7
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DOI: https://doi.org/10.1038/s41571-024-00861-7
