(UroToday.com) Platinum-based chemotherapy, sequenced with programmed cell death protein-1/programmed death-ligand 1 (PD-1/L1) inhibitors, is the standard of care for patients with advanced urothelial carcinoma. Platinum-based chemotherapy used in the first-line is associated with response rates of 36-64%, but intrinsic and acquired resistance occurs. PD-1/L1 inhibitors are used in the first-line, first-line maintenance, and in platinum-refractory disease, with durable responses, but only in a minority of patients. Patients with locally advanced or metastatic urothelial carcinoma have poor survival following progression after platinum-containing chemotherapy and PD-1/L1 inhibitor regimens. Chemotherapy, such as taxanes, have generally been recommended globally in this population, but randomized trials supporting these treatment choices is lacking. In this setting, new therapeutic agents supported by randomized data are needed.