Metastatic or Unresectable Urothelial Carcinoma with Reduced eGFR — Not Eligible for Combination Therapy
This protocol applies to patients with metastatic or unresectable urothelial carcinoma who are not candidates for combination systemic therapy due to significantly reduced renal function (eGFR), poor performance status, or a combination of both — and whose tumour PD-L1 expression is not high.
Clinical Scenario
Patients meeting one or more of the following criteria are considered ineligible for combination treatment:
- ECOG performance status > 2
- Glomerular filtration rate < 30 mL/min
- ECOG performance status 2 combined with GFR < 60 mL/min
PD-L1 expression is not high in this population. Across these fitness and renal thresholds, prognosis is poor and standard combination regimens are not appropriate.
For patients fitting this profile, a specific evidence-based protocol defines the recommended management approach. Access the full structured protocol to review the complete clinical algorithm for this scenario.
References
Patients are unfit for any platinum-based chemotherapy in case of PS > 2, GFR < 30 mL/min. or the combination of PS 2 and GFR < 60 mL/min. as the outcome in this patient population is poor regardless of whether or not platinum-based treatment is given.
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