Tailored immunotherapy for metastatic urothelial carcinoma after platinum-based chemotherapy

After failure of platinum-based chemotherapy for metastatic urothelial carcinoma, nivolumab can be used. The multicenter phase 2 TITAN-TCC trial, in Germany and Austria, investigated the safety and activity of high-dose ipilimumab as an immunotherapeutic boost in this setting. Patients received four doses of nivolumab induction. Patients with response continued maintenance nivolumab, while patients with stable or progressive disease received immunotherapy boost with nivolumab plus high dose ipilimumab. Patients who subsequently had progressive disease during nivolumab maintenance also received this boost. This approach significantly improved objective response rate after previous platinum-based chemotherapy compared with nivolumab monotherapy reported in the CheckMate-275 trial.