This protocol covers the first-line management of upper urinary tract urothelial carcinoma (UTUC) presenting as advanced or metastatic disease — including distant metastases or unresectable lymph node metastases — in patients who are eligible for enfortumab vedotin plus pembrolizumab.
The population addressed here has advanced or metastatic upper urinary tract urothelial carcinoma with distant metastases or unresectable lymph node metastases and is eligible for enfortumab vedotin plus pembrolizumab. Evidence supports enfortumab vedotin plus pembrolizumab as a first-line option in this setting, with demonstrated improvements in both progression-free survival and overall survival.
The protocol addresses systemic treatment options for this patient population, including platinum-based combination chemotherapy as one component of the treatment landscape. Specific agent selection, eligibility criteria, sequencing, and the complete regimen are detailed in the full structured protocol.
DOI: 10.1016/j.eururo.2025.02.023
Offer EV +P as first-line treatment to patients with advanced/metastatic disease.
This study showed significant improvements in both progression-free survival and OS, with a response rate of 68% for EV + P.
Offer platinum-based combination chemotherapy as a second-line treatment of choice if not received in the first-line setting.
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