(UroToday.com) The European Society of Medical Oncology (ESMO) 2021 annual meeting’s non-prostate cancer mini-oral session included a presentation by Dr. Matthew Galsky discussing results of cisplatin-related immunomodulation and efficacy with atezolizumab + cisplatin versus carboplatin-based chemotherapy in metastatic urothelial cancer. Cisplatin but not carboplatin-based chemotherapy leads to durable disease control in a subset of patients with metastatic urothelial cancer, but the underlying mechanisms remain elusive. Exploratory data from the randomized phase III IMvigor130 study1 suggest improved OS with the addition of atezolizumab to cisplatin but not carboplatin-based chemotherapy. Together, these findings raise the hypothesis that cisplatin may be associated with specific favorable immunomodulatory effects. Furthermore, the effects of cisplatin +/- atezolizumab on overall survival are most prominent in patients with PD-L1 IC-high tumors as depicted in the following table: