*This information was originally published as part of an abstract for the American Society of Clinical Oncology Genitourinary (ASCO GU) Cancers Symposium 2026*
Understanding Urothelial Carcinoma and the Unmet Patient Need
Rapid advances in first-line (1L) therapy for locally advanced or metastatic urothelial carcinoma (la/mUC) have reshaped standards of care and expanded opportunities to improve survival outcomes. The introduction of antibody-drug conjugate (ADC) plus immunotherapy (IO) combinations has redefined treatment expectations, yet these advances also introduce new complexity in eligibility determination, sequencing decisions, and adverse event management.
In community oncology settings, adoption of evolving standards may be slowed by variations in infrastructure, care coordination, and access to multidisciplinary support. As a result, gaps can emerge between guideline recommendations and real-world implementation, reinforcing the need for practical, community-informed education that supports confident integration of new regimens.
The Medlive Approach
To support adoption of emerging standards, Medlive developed a targeted educational initiative in collaboration with the Large Urology Group Practice Association (LUGPA) and the Bladder Cancer Advocacy Network (BCAN).
The curriculum included two 30-minute CME activities—“Evolving First-Line Standards of Care in la/mUC: Applying Guideline Updates to Community Practice” (Session 1) and “Operationalizing ADC + IO in 1L la/mUC: Overcoming Real-World Barriers in Community Oncology” (Session 2)—alongside a community-based Practice Pattern Analysis (PPA) Survey.
Session 1, launched in April 2025, focused on updated guidelines, eligibility considerations, sequencing strategies, and adverse event mitigation in first-line la/mUC. The PPA survey, deployed in June 2025, evaluated real-world treatment selection patterns and barriers to integrating newer regimens. Findings from the survey directly informed the development of Session 2, launched in September 2025, which provided pragmatic, case-based strategies to address identified challenges and support confident adoption of ADC plus immunotherapy combinations in eligible patients.
Outcomes were assessed using pre- and post-activity knowledge and confidence measures, along with evaluation data and survey findings to ensure alignment between educational content and real-world needs.
Key Findings
- Strong clinician engagement: More than 1,800 clinicians participated in Session 1, with 93% identifying their specialty as oncology or urology, reflecting high engagement and relevance among genitourinary oncology teams.
- Confidence gains in 1L decision-making: Participants demonstrated an approximate 25% increase in confidence in both individualizing 1L treatment selection and counseling patients about newer regimens.
- Practice intentions aligned with evolving standards: 42% of learners planned to adopt enfortumab vedotin (EV) plus pembrolizumab in eligible 1L patients, and 32% intended to reevaluate the role of platinum-based chemotherapy in this setting.
- Transitional practice patterns identified: Among PPA respondents (n=95; 77% community-based), cisplatin eligibility was the primary driver of 1L selection (65%). For cisplatin-eligible patients, 71% continued to prefer platinum-based chemotherapy with or without immunotherapy, indicating delayed uptake of guideline-preferred combinations.
- Barrier to adoption: The most commonly cited obstacle to integrating ADC plus IO regimens was adverse event management (56%), followed by sequencing complexity and patient counseling challenges.
Conclusion – Collaborating to Support Community Readiness for Evolving 1L la/mUC Standards
This two-session, practice-informed curriculum demonstrated broad engagement and measurable gains in clinician confidence for first-line decision-making in la/mUC. Integration of real-world survey data revealed a transitional phase in community adoption, with cisplatin eligibility continuing to heavily influence treatment selection and adverse event concerns limiting uptake of newer regimens.
Findings highlight the need for pragmatic educational tools that clarify ADC plus IO eligibility, standardize monitoring and mitigation strategies, and provide clear sequencing frameworks. Outcomes-driven education remains essential to aligning real-world practice with rapidly evolving evidence and ensuring patients with la/mUC receive guideline-concordant, optimized care.
To learn more about partnering with Medlive to develop impactful CME programs, reach out via our Contact Us page.
This activity was supported by an independent medical education grant from Pfizer, Inc.
