Initial Clinical Experience With Gemcitabine, Cisplatin, and Nivolumab for Advanced Urothelial Carcinoma: A Four-case Series.
Shuji Tsubota, G O Kaneko, Daisuke Igarashi et al.
✦ AI-curated · Sources linked
Case in brief
This four-case series describes patients with advanced urothelial carcinoma treated with first-line gemcitabine, cisplatin, and nivolumab (GCNivo), selected through shared decision-making. An 83-year-old woman with locally advanced bladder cancer had a radiological complete response and received consolidative bladder radiotherapy, then observation without nivolumab maintenance because of toxicity, age, and preference. A 71-year-old man with nodal recurrence had a sustained partial response and began maintenance nivolumab. A 69-year-old man initially responded but deteriorated with suspected progression and switched to enfortumab vedotin. A 75-year-old man transitioned to maintenance nivolumab after declining renal function despite disease control.
What made this case unusual
The cases illustrate divergent post-induction pathways—including radiotherapy followed by observation, maintenance nivolumab, and a switch to second-line therapy—despite initial treatment with the same regimen.
Diagnostic / clinical pearl
After GCNivo induction, assess response and tolerability alongside renal function, toxicity, and patient preference when determining subsequent management.
Why it matters
The series highlights how shared decision-making can shape both first-line treatment selection and individualized management after induction.