(UroToday.com) Platinum-based cytotoxic chemotherapy has been the standard of care for patients with advanced urothelial carcinoma (UC) based on improved survival compared to placebo. However, objective response rates are at best 50% and median overall survival is relatively poor at less than 18 months. As a result, there have been numerous efforts to improve these outcomes. One such attempt was to add immune checkpoint inhibition to chemotherapy. This approach was used in the phase III KEYNOTE-361 study which compared first-line pembrolizumab + chemotherapy or pembrolizumab vs chemotherapy in patients with advanced UC.