Metastatic or Unresectable Urothelial Carcinoma with Contraindications to Enfortumab Vedotin and Checkpoint Inhibitor Therapy
This first-line protocol addresses patients with metastatic or unresectable urothelial carcinoma who cannot receive enfortumab vedotin or checkpoint inhibitor therapy. The treatment goal is objective response.
Clinical Scenario
Metastatic or unresectable urothelial carcinoma — ECOG performance status 0–2, glomerular filtration rate ≥ 30 mL/min — with documented contraindications to both enfortumab vedotin and checkpoint inhibitor therapy.
Treatment Approach (Partial)
When both enfortumab vedotin and checkpoint inhibitor therapy are contraindicated, the recommended first-line approach involves platinum-containing combination chemotherapy. The complete regimen, sequencing, and all relevant details are available in the structured protocol.
References
If contraindications for EV and CPI therapy: Use platinum-containing combination chemotherapy (cisplatin or carboplatin plus gemcitabine).
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