(UroToday.com) Platinum-based cytotoxic chemotherapy has been the standard of care for patients with advanced urothelial carcinoma 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. This has driven the rationale for additional approaches. In first-line (1L) therapy for patients who are not cisplatin-eligible and as maintenance or second-line therapy (2L) for patients receiving first-line chemotherapy, immune checkpoint therapy has become the standard of care. However, treatment for patients who have previously received programmed death 1/ligand 1 inhibitor (PD-1/L1i) therapy.