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First-line immune-combination therapies in mUC

ESMO 2020
Phase 3, KEYNOTE-361
Two trials, KEYNOTE-361 and DANUBE, explored the efficacy of first-line treatment of patients with metastatic urothelial cancer (mUC) with an immune checkpoint inhibitor combined with either chemotherapy or a second immune checkpoint inhibitor. None of the studies met its endpoint. The current first-line treatment for mUC is platinum-based chemotherapy or best supportive care in case of platinum-ineligibility. Recently, monotherapy with pembrolizumab and atezolizumab were approved for patients with PD-L1 positive disease [1,2]. In the open-label, phase 3 KEYNOTE-361 study, 1,010 patients with unresectable or mUC and who had no prior systemic therapy for advanced disease were 1:1:1 randomised to receive pembrolizumab (200 mg every 3 weeks up to 35 cycles), pembrolizumab plus chemotherapy (gemcitabine plus cisplatin or carboplatin) or chemotherapy [3]. Median progression-free survival (PFS) was 8.3 months in the pembrolizumab plus chemotherapy arm ve...

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