Several immunotherapy failures of the urinary road skin cancer ushered in a new pattern of first-line maintenance treatment.

Vencoon pieurine path skin cancer (UC) originated from transcutaneous, the vast majority of which originated from the bladder (about 90%), for the initial treatment of metastatic urinary skin cancer, platinum-based chemotherapy is the standard treatment, but the total survival is short (about 9-15 months), the total survival rate of 5 years is only about 5%For patients with first-line platinum chemotherapy failure, the prognosis is very poor, with a median survival of about 5-7 months and no treatment plan for extended total survival;in recent years, immunocheckpoint inhibitors represented by anti-PD-1/PD-L1 monoabhash have achieved great success in the field of tumor treatment, especially melanoma, non-small cell lung cancer, kidney cancer, head and neck phosphorus cancer, etcrecent phase III clinical studies of immunotherapy have also welcomed new data, the results of which, we will find out exactlyIMvigor130 is a multicenter, partially blind, randomized Phase III study designed to assess the efficacy and safety of ametreizumab or chemotherapy alone in treating metastatic UC patients who have not received systemic treatmentA total of 1,213 patients were recruited and randomly treated with the following therapies: Group A: Tecentriq plus platinum chemotherapy (Giciitabin and cisplatin or carppel), Group B: Tecentriq monodrug, Group C: Platinum chemotherapy (giciitabin and cisplatin or carplatinum) and placebo (control group)The main endpoints are OS and PFS, which are evaluated by the researchers using the RECIST v1.1 response evaluation criteriaresults showed that the median PFS in Group A and Group C were 8.2 months and 6.3 months, respectively, achieving a statistically significant difference, while the OS in the two groups was 13.4 months and 16.0 months, respectively, and the statistically significant differences were not yet reachedThe objective remission rate (ORR) and efficacy duration data were also similar in the two groups: 47% and 44% of the objective efficacy, respectively, and 8.5 months and 7.6 months of efficacy duration, respectivelyIn addition, group B did not improve OS compared to Group C, the mid-term analysis prompted no improvementKEYNOTE-361 is a randomized, open-label Phase III clinical trial involving 1010 patients designed to evaluate the efficacy and safety of PabolyZumab, Paboli Zuma, and Paboli Zuma, compared to standard chemotherapy for first-line treatment of patients with advanced UCPatients were randomly divided into three groups: 1) Pabolyzumab; 2 Paboli-Zuma supma; and 3) chemotherapy aloneThe chemotherapy regimen uses Gisitabin, cisplatin, carplatinThe main endpoints of the study were OS and PFS, and the secondary endpoints included response duration, disease control rate, total response rate, and safetyThe final analysis of thestudy showed that patients with Paboli zumas in combination with chemotherapy, while improving both OS and PFS, did not meet the statistical differences between pre-specified groups compared to chemotherapy alone Danube is a randomized, open-label, multi-center, global Phase III trial conducted as a first-line therapy in patients with non-removability, phase IV UC, evaluating the efficacy and safety of the Monovalinu monotherapy (Imfinzi), Imfinzi joint anti-CTLA-4 therapy tremelimumab , according to new data published, 1) Imfinzi monodrug therapy failed to improve the total survival (OS) of patients in tumor cells or tumor-immersed immune cells (-25%) compared to standard care chemotherapy(25%) of PD-L1; As a result, the study failed to reach the primary endpoint Avelumab is a PD-L1 monotag developed by Pfizer and Merck The JAVELIN Bladder 100 study is a first-line multicenter, randomized Phase III clinical trial designed to assess the efficacy and safety of Avelumab Combined SupportIve Therapy (BSC) in first-line maintenance therapy in locally advanced or metastatic UC patients study included 700 patients with non-surgical, non-surgical locally advanced or metastatic urethra skin cancer who did not show disease progression after receiving platinum-based induced chemotherapy, and received Alumveab joint optimal support treatment or individual best support treatment according to 1:1 random distribution The main endpoint of the study was OS, and the secondary endpoint included PFS, ORR, and safety data cut-off, the median follow-up time for the Avelumab joint group (n-350) and the individual best support treatment group (n-350) was 19.6 and 19.2 months, respectively Of the 700 patients included in the study, 358 (51%) were positive for PD-L1 the best support treatment alone, Avelumab combined optimal support therapy significantly improved the oS of patients, reducing the risk of death by 31% (HR.69, 95% CI: 0.56 to 0.86, one-sided P-0.0005), with the median OS in the two groups at 21.4 months and 14.3 months, respectively in patients with positive PD-L1 expression, Avelumab combined optimal support therapy also significantly improved OS (HR.56, 95% CI: 0.40 to 0.79, one-sided P-0.0003), Avelumab joint best support treatment group did not reach the oS, while the single best support treatment group ranked OS was 17.1 months In addition, improvements in OS were observed in all pre-set subgroups the overall population (HR.62, 95% CI: 0.52 to 0.75) or PD-L1 positive population (HR-0.56, 95% CI: 0.43 to 0.73), Avelumab combined optimal support treatment has led to an improvement in PFS (BIRC assessment) after several failed immunological studies, the success of the JAVELIN Bladder 100 study offers hope to patients with late-stage urinary skin cancer JAVELIN Bladder 100 study marks the first time in phase III trials that an immunotherapy has shown better OS data than standard care in first-line treatment of locallate or metastatic UC, and has achieved a significant improvement in total survival, a major breakthrough in the field of first-line therapy Avelumab is expected to reshape the first-line maintenance treatment for late-stage urinary tract cancer .