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Algorithm for first line chemotherapy for metastatic UC



       from July 2018






































                                  Number                         PD-L1 biomarker                 Response  in PD-                Overall survival
                                                                                                         L1 +ve                    In PD-L1 +ve



      atezolizumab                           32                     SP142 (>5%                            28%                    12.3 months
                                                                            IC)                        (14-47)                         (6-NE)                         Balar et al
                                                                                                                                                                      Lancet 2016

     pembrolizumab                          110                      22C3 CPS                             47%                    18.5 months                          and17

                                                                          10%                         (38-57)                     (12.2-28.5)
   2   3   4   5   6   7   8   9   10   11   12