New Choices in Targeted Treatments for Advanced or Metastatic Urothelial Carcinoma: Plot Your Own Course




Supported by an educational grant from EMD Serono, Inc. and Pfizer, Inc.


Provided by Integrity Continuing Education, Inc.


Release date: November 23, 2020
Expiration date: November 23, 2021
Estimated time to complete activity: 45 minutes



Thomas Powles, MBBS, MRCP, MD
Professor, Centre of Experimental Cancer Medicines
Bart’s Cancer Institute
St. Bartholomew’s Hospital
London, United Kingdom


Brian Rini, MD, FASCO
Chief of Clinical Trials
Department of Hematology/Oncology
Vanderbilt University Medical Center
Nashville, Tennessee


In advanced or metastatic urothelial carcinoma (UC) a heavily cytotoxic “sledgehammer” approach has traditionally been used. Platinum-based chemotherapy is still the preferred first-line approach. But this non-specific cytotoxic treatment is often intolerable for the typically older UC patient.

Until recently, there were no second-line options beyond the chemotherapeutic sledgehammer. Today, treatments with more selective mechanisms of action take advantage of fresh translational insights into UC.

These novel therapeutics offer more efficient targeting for patients who have run out of options. But for clinicians, the introduction of these agents complicates an already complex condition. This activity will guide them in selecting and using these options.

In this case-based activity you will navigate a simulated patient case, making clinical decisions when prompted. Feedback regarding your decisions will be provided as you move through the case.


This educational initiative has been designed for genitourinary oncologists, medical oncologists, surgical oncologists, radiologists, urologists, nurse practitioners (NPs), physician assistants (PAs), clinical nurse specialists (CNSs), advanced practice nurses (APNs), oncology clinical nurses (OCNs), and clinical oncology pharmacists (BCOPs) involved in the care and coordination of patients with urothelial carcinoma (UC).


Upon completion of this educational activity, participants should be able to:

  • Articulate the mechanisms of action of targeted biopharmacologics and immune checkpoint inhibitors (ICIs) used in the treatment of UC
  • Outline efficacy and safety findings from key clinical trials of approved and investigational novel treatments developed for the treatment of advanced or metastatic UC (mUC)

There are no fees for participating and receiving CME credit for this activity. During the period of November 23, 2020 through November 23, 2021, participants must:

  • Read this CME information page

  • Complete the pretest

  • Navigate the case-based activity either in Twitter or here

  • Complete the posttest and the evaluation form

A statement of credit will be issued only upon receipt of a completed activity evaluation form and a completed posttest with a score of 70% or better.




Integrity Continuing Education, Inc is accredited with commendation by the Accreditation Council for Continuing Medical Education to provide continuing medical education (CME) for physicians.


Integrity Continuing Education, Inc designates this enduring material for a maximum of 0.75 AMA PRA Category 1 Credit(s). Physicians should claim only the credit commensurate with the extent of their participation in the activity.


For information about ACCME accreditation of this activity, please contact Integrity Continuing Education, Inc. at (855) 835-4004 or


Integrity Continuing Education, Inc requires instructors, planners, managers, and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest they may have as related to the content of this activity. All identified conflicts of interest are thoroughly vetted by Integrity Continuing Education, Inc for fair balance, scientific objectivity of studies mentioned in the materials or used as the basis for content, and appropriateness of patient care recommendations.

The following faculty/planners reported the financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of these CME activities:

Thomas Powell, MD
Consulting Fees: AstraZeneca, Bristol Myers Squibb, Exelixis, Incyte, Ipsen, Merck/Merck Sharp & Dohme, Novartis, Pfizer, Seattle Genetics, Merck Serono, Astellas, Johnson & Johnson, Eisai, and Roche

Contracted Research: AstraZeneca, Roche, Bristol Myers Squibb, Exelixis, Ipsen, Merck/Merck Sharp & Dohme, Novartis, Pfizer, Seattle Genetics, Merck Serono, Astellas, Johnson & Johnson, and Eisai

Other: Expenses/Travel/Accommodation: Roche, Pfizer, Merck Sharp & Dohme, AstraZeneca, and Ipsen

Brian Rini, MD
Consulting Fees: Merck, Pfizer, Bristol Myers Squibb, Aravive, AVEO Pharmaceuticals, GlaxoSmithKline

Contracted Research: Merck, Bristol Myers Squibb, Exelixis, Pfizer, AstraZeneca

Michelle R. Rizzo, ELS, hereby states that she or her spouse/life partner do not have any financial relationships or relationships to products or devices with any commercial interest related to the content of this activity of any amount during the past 12 months.


This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. Integrity Continuing Education, Inc., EMD, Serono, Inc., and Pfizer, Inc. do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of any organization associated with this activity. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.


When you participate in an online educational activity sponsored by Integrity Continuing Education, Inc, you will be asked for your name, degree(s), affiliation(s), street address, telephone number, and…(continued)


Minimum Processor: Intel Pentium 4, 2.33 + GHz (or equivalent)
Operating Systems: Windows XP, Windows 2000, Windows Vista, Windows 7, Windows 10, and Mac OS
Plug-in: Adobe® Flash® Player 10

  • Adobe® Flash® Player 10 plug-in should be downloaded
  • Click on the “Agree and install now” button after unchecking the optional McAfee Security Scan Plus

For optimal performance, the use of Internet Explorer below 8 is not recommended.
For a full listing of recommended operating systems, browsers, and system configurations, please click on the link below:

Click here for more information on minimum system requirements


The information provided at this activity is for continuing education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient’s medical condition.



Continue to Pretest