Page 11 - Management of Advanced Urothelial Carcinoma: Emerging Therapies and Biomarkers

Management Algorithm (2/3)

LOCALLY ADVANCED OR METASTATIC UROTHELIAL CARCINOMA

PD-L1 IHC Assay (if not performed previously)

FGFR gene alteration assay

FIRST- LINE
THERAPY Cisplatin ineligible Platinum
METASTATIC Cisplatin eligible PD-L1 positive PD-L1 negative ineligible
UROTHELIAL
CARCINOMA
IO therapy ‡
Cisplatin + Alternative: Carboplatin Carboplatin + IO therapy ‡
Alternative:
gemcitabine gemcitabine
+ gemcitabine gemcitabine

‡ Approved for 1L
FGFR, fibroblast growth factor receptor; IHC, immunohistochemistry; IO, immuno-oncology; NGS, next generation sequencing; PD-L1, programmed death ligand 1; RT-PCR, reverse
transcription polymerase chain reaction.