Dr. Alan Tan leads a discussion with Dr. Brad McGregor and Dr. Amanda Nizam on how EV plus pembrolizumab has redefined frontline treatment in metastatic urothelial cancer, delivering unprecedented response rates and survival gains. The conversation explores practical challenges such as managing cumulative neuropathy, where early dose modification is key to maintaining both efficacy and quality of life, and highlights the emerging but still exploratory role of ctDNA in guiding treatment decisions. Looking ahead, the group emphasizes the urgent need to improve outcomes beyond EV plus pembrolizumab through novel combinations, including dual antibody-drug conjugates and HER2-targeted strategies, while reinforcing the importance of comprehensive biomarker testing to guide next-line therapy.
Contributors:
Dr. Alan Tan is a medical oncologist practicing at Vanderbilt-Ingram Cancer Center in Nashville, Tennessee.
Dr. Amanda Nizam is a genitourinary medical oncologist practicing at Clevelant Clinic in Cleveland, Ohio.
Dr. Brad McGregor is a medical oncologist and the Director of Clinical Research at the Lank Center of Genitourinary Oncology in Boston, Massachusetts.