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. 2024 Apr;22(2):330-335.
doi: 10.1016/j.clgc.2023.12.001. Epub 2023 Dec 13.

First-line Management of Metastatic Urothelial Cancer: Current and Future Perspectives After the EV-302 and CheckMate-901 Studies

María Dolores Fenor de la Maza  1 , Guillermo Villacampa  2 , Bernardino Miñana  3 , Guillermo Barbas Bernardos  3 , Guillermo Andrés  3 , Daniel Antonio González-Padilla  3 , Fernando Ramón de Fata  3 , Julián Sanz  4 , Mauricio Cambeiro  5 , Javier Aristu  5 , Alfonso Gúrpide  6 , Felipe Villacampa  3 , Jose Luis Pérez Gracia  6
Affiliations

First-line Management of Metastatic Urothelial Cancer: Current and Future Perspectives After the EV-302 and CheckMate-901 Studies

María Dolores Fenor de la Maza et al. Clin Genitourin Cancer. 2024 Apr.

Abstract

The standard of care for the first-line management of metastatic urothelial carcinoma has been recently challenged, with the combination of pembrolizumab and enfortumab vedotin (P-EV) strongly arising as a practice-changing option from classical platinum-based chemotherapies. With this paradigm shift on the horizon new questions, including the most suitable second line of treatment for these patients, and the role that the molecular characterization of these tumours will have when selecting these therapies will inevitably arise. Furthermore, after the negative results of the Keynote 361 and IMvigor 130 trials, the combination of nivolumab with platinum-based chemotherapy followed by nivolumab maintenance (Nivo GC-Nivo) has also shown positive results when compared with chemotherapy alone. Translational studies at a molecular, cellular, and functional level will be key to better explain these discordant results. In this Current Perspective, we discuss the potential impact of these results in clinical practice and propose specific guidance for prospective translational research.

Keywords: Immune therapy; Molecular characterization; Paradigm shift; Personalized treatment; Sequence of treatments.

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Conflict of interest statement

Disclosure M.D.F. has received grants fees from “Fundación Cris contra el Cáncer”, travel fees from Astellas, AstraZeneca, Pfizer, Pierre Fabre, Roche, Bristol Meiers Squibb, Novartis, MSD, Janssen, MERK, Ipsen and Bayer Pharmamar, and speakers’ bureau from Janssen, Pierre Fabre and Roche. All outside the submitted work. G.V. has received speaker's fees from MSD, GSK, Pfizer and Pierre Fabre, and has held an advisory role with AstraZeneca. All outside of the submitted work. J.L.P.G. has received research grants and support from Astellas, Amgen, BMS, MSD, Novartis, Roche, Seattle Genetics, speakers’ bureau and advisory boards from Astellas, MSD, Roche, and travel support from BMS, MSD, Roche, Merck. All outside the submitted work. The rest of authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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