Overview

• Guidance applies to adults with unresectable or metastatic urothelial cancer who are eligible for platinum-containing chemotherapy.
• NHS England will fund and roll out the regimen under confidential commercial arrangements, with access required within 90 days of final guidance.
• In the phase 3 EV-302 study (886 patients), median overall survival was about 33.8 months with the combination versus 15.9 months with chemotherapy, and median progression-free survival was 12.5 versus 6.3 months.
• The therapy produced higher response rates, including objective responses in roughly 68% and complete responses in around 30% compared with 44% and 12–14.5% on chemotherapy.
• Clinicians describe this as the first major shift in first-line care since the 1980s, with an estimated 1,200–1,250 patients in England expected to benefit each year.