My Treatment Approach: Navigating First-Line Treatment Options in Locally Advanced and Metastatic Urothelial Cancer

Thomas Powles, MBBS, MRCP, MD, discusses currently available treatment options for previously untreated locally advanced and metastatic urothelial cancer. He presents a hypothetical clinical scenario and discusses his treatment approach to illustrate how he incorporates recent data into his clinical practice.

EP. 1: Outlining the Current First-Line Treatment Landscape in Metastatic Urothelial Cancer: Starting With a Cisplatin-Ineligible Patient Case

November 22nd 2024

Thomas Powles, MBBS, MRCP, MD, discusses how upon examining an elderly patient experiencing hematuria, they were found to have had a transurethral resection of a bladder tumor, which revealed the presence of muscle-invasive bladder cancer. The patient is determined to have metastatic disease and is ineligible for cisplatin chemotherapy in the first line.

EP. 2: Single-Agent Immune Therapy in UC: The Need for More

November 22nd 2024

Thomas Powles, MBBS, MRCP, MD, discusses how different trials have been used to study urothelial cancer (UC) treatments, including DANUBE, IMvigor130, and KEYNOTE-361, all of which are frontline, randomized, phase 3 studies that were unsuccessful. A trial that had better results involved nivolumab plus gemcitabine/cisplatin, due to patients being in better physical condition to withstand chemotherapy.