Enfortumab Vedotin and Pembrolizumab - A New Perspective on Urothelial Cancer

For several decades, platinum-based chemotherapy has been the standard first-line option for patients with advanced inoperable or metastatic (or both) urothelial carcinoma. This paradigm, in which platinum-based chemotherapy was considered to be the only effective first-line chemotherapy, was implemented in the 1980s(1) and remained unchanged even after immune checkpoint inhibitors were introduced in recent years as part of the treatment regimen for metastatic urothelial carcinoma. Treatment advances were made by replacing older treatments with less toxic combinations (e.g., gemcitabine and cisplatin(2)) or by replacing cisplatin with carboplatin in patients who were ineligible to receive cisplatin(3) rather than by improving treatment . . .