Applying Real-World Evidence to Individualized Treatment Sequencing in Advanced Urothelial Carcinoma

This segment focuses on how clinicians use real-world evidence to individualize treatment sequencing in advanced urothelial (bladder) cancer, especially when patients do not fit classic clinical trial profiles. The discussion reviews options after platinum-based chemotherapy and maintenance immunotherapy, including antibody–drug conjugates and biomarker-driven approaches targeting FGFR3 alterations and HER2 overexpression.

The speakers explain how trial results, typically reported as median outcomes, mask wide variation: some patients do much better, others worse. Real-world data help refine expectations and guide choices when actual responses diverge from what trials predict. The segment emphasizes the “art of medicine” within guideline-based care, adapting therapy to comorbidities, prior tolerance, patient goals, and evolving evidence.

Looking forward, the conversation highlights the convergence of better therapeutics and better diagnostics, such as minimal residual disease testing and more sensitive imaging, as a near-term opportunity to redefine how bladder cancer is managed across the disease continuum.