Study study type PathologyT1T0Patientssample sizesROB Results

mUC - L1 - all population metastatic/advanced UC (mUC) - 1st Line (L1) mUC - L1 - all population

versus gemcitabine plus platin
atezolizumab alone
IMvigor-130 (At-arm B vs Ch-armC), 2020
  NCT02807636
RCTmUC - L1 - all populationatezolizumab (B)chemotherapy (C) gemcitabine plus platinepatients with untreated locally advanced or metastatic urothelial carcinoma360 / 400some concern
inconclusive
  • inconclusive 2 % increase in deaths (OS) (PE)
  • statistically significant 62 % decrease in objective responses (ORR)
durvalumab alone
DANUBE (D vs C - all population), 2020
  NCT02516241
RCTmUC - L1 - all populationdurvalumabplatine based chemotherpy (SOC) cisplatine plus gemcitabinefirst line in Patients with Stage IV Urothelial Cancer.346 / 344some concern
inconclusive
  • statistically significant 64 % decrease in objective responses (ORR)
durvalumab plus tremelimumab
DANUBE (DT vs C - all population), 2020
  NCT02516241
RCTmUC - L1 - all populationdurvalumab plus tremelimumabplatine based chemotherpyfirst line in Patients with Stage IV Urothelial Cancer.342 / 344some concern
inconclusive
  • inconclusive 15 % decrease in deaths (OS) (PE)
  • statistically significant 41 % decrease in objective responses (ORR)
pembrolizumab plus SoC
KEYNOTE-361 (PC vs C), 2021
  NCT02853305
RCTmUC - L1 - all populationpembrolizumab plus chemotherapychemotherapy alone (cisplatine or carbo plus gemcitabine)patients with histologically or cytologically confirmed unresectable/metastatic urothelial carcinoma, who received no prior systemic chemotherapy for advanced urothelial cancer351 / 352some concern
inconclusive
  • inconclusive 14 % decrease in deaths (OS) (PE)
  • suggested 22 % decrease in progression or deaths (PFS) (PE)
versus placebo plus SoC
atezolizumab plus SoC
IMvigor-130 (At-arm A vs Pl-arm C), 2020
  NCT02807636
RCTmUC - L1 - all populationatezolizumab (A) plus gemcitabine and platineplacebo (C) plus gemcitabine and platinepatients with untreated locally advanced or metastatic urothelial carcinoma451 / 400some concern
conclusif
  • inconclusive 17 % decrease in deaths (OS) (PE)
  • demonstrated 18 % decrease in progression or deaths (PFS) (PE)
versus Standard of Care (SoC)
pembrolizumab alone
KEYNOTE-361 (P vs C), 2021
  NCT02853305
RCTmUC - L1 - all populationpembrolizumabchemotherapy alone (cisplatine or carbo plus gemcitabine)patients with histologically or cytologically confirmed unresectable/metastatic urothelial carcinoma, who received no prior systemic chemotherapy for advanced urothelial cancer307 / 352some concern
inconclusive
  • statistically significant 35 % increase in progression or deaths (PFS)
  • statistically significant 47 % decrease in objective responses (ORR)

mUC - L1 - PDL1 positive metastatic/advanced UC (mUC) - 1st Line (L1) mUC - L1 - PDL1 positive

versus gemcitabine plus platin
durvalumab alone
DANUBE (D vs C - PDL1>25%), 2020
  NCT02516241
RCTmUC - L1 - PDL1 positivedurvalumabplatine based chemotherapy (gemcitabine)first line in Patients with Stage IV Urothelial Cancer whose tumours express high levels of PD-L1.209 / 207some concern
inconclusive
  • inconclusive 11 % decrease in deaths (OS) (PE)
  • statistically significant 59 % decrease in objective responses (ORR)
durvalumab plus tremelimumab
DANUBE (DT vs C - PDL1>25%), 2020
  NCT02516241
RCTmUC - L1 - PDL1 positivedurvalumab plus tremelimumabplatine based chemotherpy (SOC)first line in Patients with Stage IV Urothelial Cancer with PDL1 high expression level205 / 207some concern
suggested
  • suggested 26 % decrease in deaths (OS)

mUC - L2 - all population metastatic/advanced UC (mUC) - 2nd Line (L2) mUC - L2 - all population

versus Standard of Care (SoC)
atezolizumab alone
IMvigor-211 (all population), 2018
  NCT02302807
RCTmUC - L2 - all populationatezolizumabchemotherapypatients with locally advanced or metastatic urothelial bladder cancer (UBC) who have progressed during or following a platinum-containing regimen patients had received no more than two previous lines of therapy and had progressed during or following one or more platinum-containing regimens for metastatic urothelial carcinoma (or neoadjuvant or adjuvant therapy with progression)467 / 464some concern
suggested
  • suggested 15 % decrease in deaths (OS) (PE)
  • suggested 18 % decrease in deaths (OS) (extension)
pembrolizumab alone
KEYNOTE-045 (all population), 2017
  NCT02256436
RCTmUC - L2 - all populationpembrolizumabchemotherapy (ICC) : paclitaxel, docetaxel, or vinfluninepatients with advanced urothelial carcinoma that progressed during or after the receipt of platinumbased chemotherapy treated as second-line therapy270 / 272some concern
conclusif
  • demonstrated 27 % decrease in deaths (OS) (PE)
  • inconclusive 2 % decrease in progression or deaths (PFS) (PE)
  • suggested 30 % decrease in deaths (OS) (extension)
  • demonstrated 1.1-fold increase in objective responses (ORR) (PE)
  • more...

mUC - L2 - PDL1 positive metastatic/advanced UC (mUC) - 2nd Line (L2) mUC - L2 - PDL1 positive

versus Standard of Care (SoC)
atezolizumab alone
IMvigor-211 (PDL1>5%), 2018
  NCT02302807
RCTmUC - L2 - PDL1 positiveatezolizumabchemotherapypatients with locally advanced or metastatic urothelial bladder cancer (UBC) who have progressed during or following a platinum-containing regimen patients had received no more than two previous lines of therapy and had progressed during or following one or more platinum-containing regimens for metastatic urothelial carcinoma (or neoadjuvant or adjuvant therapy with progression)116 / 118some concern
inconclusive
  • inconclusive 13 % decrease in deaths (OS) (PE)
IMvigor-211 (PDL1>1%), 2018
  NCT02302807
RCTmUC - L2 - PDL1 positiveatezolizumabchemotherapypatients with locally advanced or metastatic urothelial bladder cancer (UBC) who have progressed during or following a platinum-containing regimen patients had received no more than two previous lines of therapy and had progressed during or following one or more platinum-containing regimens for metastatic urothelial carcinoma (or neoadjuvant or adjuvant therapy with progression316 / 309some concern
suggested
  • inconclusive 13 % decrease in deaths (OS) (PE)
pembrolizumab alone
KEYNOTE-045 (PDL1 CPS >10%), 2017
  NCT02256436
RCTmUC - L2 - PDL1 positivepembrolizumabchemotherapy (ICC)as second-line therapy in patients with advanced urothelial carcinoma that progressed during or after the receipt of platinumbased chemotherapy.=> only PDL1 CPS >10%74 / 90some concern
conclusif
  • demonstrated 43 % decrease in deaths (OS) (PE)
  • inconclusive 11 % decrease in progression or deaths (PFS) (PE)

mUC - M - all population metastatic/advanced UC (mUC) - maintenance (M) mUC - M - all population

versus BSC
avelumab alone
JAVELIN Bladder 100 (all population), 2020
  NCT02603432
RCTmUC - M - all populationavelumabBSCas first line therapy, previously untreated locally advanced or metastatic urothelial carcinoma whose disease did not progress on induction chemotherapy350 / 350some concern
conclusif
  • demonstrated 31 % decrease in deaths (OS),deaths (OS) (PE)
  • suggested 24 % decrease in deaths (OS) (extension),deaths (OS) (extension)
  • suggested 46 % decrease in PFS (extension),PFS (extension)
  • suggested 38 % decrease in progression or deaths (PFS),progression or deaths (PFS)

mUC - M - PDL1 positive metastatic/advanced UC (mUC) - maintenance (M) mUC - M - PDL1 positive

versus BSC
avelumab alone
JAVELIN Bladder 100 (PDL1>25%), 2020
  NCT02603432
RCTmUC - M - PDL1 positiveavelumabno treatmentpreviously untreated locally advanced or metastatic urothelial carcinoma whose disease did not progress on induction chemotherapy189 / 169some concern
conclusif
  • demonstrated 44 % decrease in deaths (OS),deaths (OS) (PE)
  • suggested 31 % decrease in deaths (OS) (extension),deaths (OS) (extension)
  • suggested 54 % decrease in PFS (extension),PFS (extension)
  • suggested 44 % decrease in progression or deaths (PFS),progression or deaths (PFS)

MIBC - NA - all population muscular invasive bladder cancer (MIBC) MIBC - (neo)adjuvant (NA) MIBC - NA - all population

versus no additional treatment
atezolizumab alone
IMvigor-010, 2021
  NCT02450331
RCTMIBC - (neo)adjuvant (NA)atezolizumabobservationpatients aged 18 years or older and had histologically confirmed muscle-invasiveurothelial carcinoma of either the bladder or the upper tract as Adjuvant Therapy (Participants With High-Risk Muscle-Invasive Urothelial Carcinoma)406 / 403some concern
inconclusive
  • inconclusive 11 % decrease in events or deaths (EFS),events or deaths (EFS) (PE)
versus placebo
nivolumab alone
CheckMate 274 (all population), 2017
  NCT02632409
RCTMIBC - NA - all populationnivolumabplaceboadjuvant therapy patients with muscle-invasive high-risk urothelial carcinoma who had undergone radicalsurgery353 / 356low
conclusif
  • suggested 28 % decrease in RFS/DFS
  • demonstrated 30 % decrease in events or deaths (EFS) (PE)

MIBC - NA - PDL1 positive muscular invasive bladder cancer (MIBC) MIBC - (neo)adjuvant (NA) MIBC - NA - PDL1 positive

versus placebo
nivolumab alone
CheckMate 274 (PDL1>1%), 2017
  NCT02632409
RCTMIBC - NA - PDL1 positivenivolumabplaceboadjuvant therapy patients with muscle-invasive high-risk urothelial carcinoma who had undergone radicalsurgery140 / 142low
conclusif
  • suggested 45 % decrease in RFS/DFS
  • demonstrated 45 % decrease in events or deaths (EFS) (PE)