Treatment and Sequencing Strategies: Providing the Best Care for Patients with Metastatic Urothelial Carcinoma (mUC)

This activity is part of a series


Daniel P. Petrylak, MD
Professor of Medicine (Medical Oncology) and Urology Yale School of Medicine
Co-Director, Signal Transduction Research Program Smilow Cancer Center New Haven, CT
Daniel P. Petrylak, MD

Daniel P. Petrylak, MD, was appointed to lead the genitourinary cancers medical oncology team at Smilow Cancer Hospital as Director of the prostate cancer research group, Professor, and Co- Director of the Signal Transduction Research Program. He joined Yale from New York-Presbyterian Hospital/Columbia University Medical Center, where he served as a Professor of Medicine and began his appointment in September 2012. He is a member of the American Association for Cancer Research, American Society for Clinical Oncology, American College of Physicians, American Association for the Advancement of Science, American Urological Association, and the Southwest Oncology Group. Dr. Petrylak currently serves as the Principal Investigator or Co-Principal Investigator on nine Southwest Oncology Group (SWOG) clinical trials for genitourinary cancers and has led the advanced bladder cancer subcommittee for SWOG since 1995. Additionally, he has led multiple national and international studies in prostate and bladder cancer.

Dr. Petrylak’s research interests span both prostate and bladder cancer. He led an investigator-initiated trial of docetaxel and estramustine in castration-resistant prostate cancer. The results of this study supported a phase III trial of this combination in SWOG led by Dr. Petrylak, which in turn, supported the FDA approval of docetaxel for castration-resistant prostate cancer. This was one of the first two trials to demonstrate a survival benefit in this state of disease. Dr. Petrylak has also been instrumental in the development of immunotherapy and targeted therapies for refractory bladder cancer. His work with enfortumab vedotin has supported the accelerated approval of this drug.

Dr. Petrylak received his undergraduate degree from Columbia College and his medical degree from Case Western University School of Medicine. He completed his internship and residency at Albert Einstein College of Medicine and his fellowship in medical oncology at Memorial Sloan-Kettering Cancer Center. Dr. Petrylak has authored more than 140 peer-reviewed articles and book chapters on prostate and bladder cancer research outcomes.

Guru Sonpavde, MD
Bladder Cancer Director Dana Farber Cancer Institute
Associate Professor of Medicine Harvard Medical School Boston, MA
Guru Sonpavde, MD

Guru P. Sonpavde, MD, is a medical oncologist and the Bladder Cancer Director at the Dana Farber Cancer Institute as well as Associate Professor of Medicine at Harvard Medical School. At Dana-Farber, he leads multiple cutting-edge clinical trials studying novel immunotherapy and targeted drugs to cure bladder cancer. He is the national or international Principal Investigator of multiple clinical trials for patients with bladder cancer. Dr. Sonpavde has also led translational projects and developed prognostic classifications and clinical endpoints focused on bladder cancer. He is a member of Southwest Oncology Group (SWOG) and Bladder Cancer Task Force of the U.S. NCI GU Steering Committee.

Statement of Need

The need for second-line (2L) treatment strategies in locally advanced and metastatic UC (mUC) is imperative, as most patients will have disease progression within ~9 months of first-line (1L) therapies. Clinical management is challenged by heterogeneous patient populations, which underscores the need to optimize 2L treatments that yield durable response.

This CMEOCast podcast features expert faculty evaluating efficacy data for 1L and 2L sequencing strategies in patients with mUC highlighting immune checkpoint inhibitors and other novel agents, as well as provide strategies for managing adverse events during treatment.

Learning Objectives

At the end of this CME/CE activity, participants should be able to utilize upfront treatment and sequencing strategies in MUC immunotherapy to provide the best care with 2L treatment options.

The following learning objectives pertain only to those requesting CNE or CPE credit: Identify upfront treatment and sequencing strategies in MUC immunotherapy used to provide the best care with 2L treatment options.

Financial Support

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

Target Audience

Oncologists, PAs, nurse practitioners, nurses, and pharmacists.

Credit Information

Physicians (ACCME)

CME Outfitters, LLC, is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. CME Outfitters, LLC, designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Pharmacists (ACPE)

This application-based activity is approved for 1.0 contact hour (0.10 CEUs) of continuing pharmacy credit. Jump to Activity UAN.


Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 MOC point in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

Royal College MOC

Through an agreement between the Accreditation Council for Continuing Medical Education and the Royal College of Physicians and Surgeons of Canada, medical practitioners participating in the Royal College MOC Program may record completion of accredited activities registered under the ACCME’s “CME in Support of MOC” program in Section 3 of the Royal College’s MOC Program.

Note to Nurse Practitioners

Nurse Practitioners can apply for AMA PRA Category 1 Credit through the American Academy of Nurse Practitioners (AANP). AANP will accept AMA PRA Category 1 Credit  from organizations accredited by the Accreditation Council for Continuing Medical Education. Nurse practitioners can also apply for credit through their state boards.

MIPS Improvement Activity

This activity counts towards MIPS Improvement Activity requirements under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Clinicians should submit their improvement activities by attestation via the CMS Quality Payment Program website.

Note to Physician Assistants

AAPA accepts certificates of participation for educational activities certified for AMA PRA Category 1 Credit  from organizations accredited by the Accreditation Council for Continuing Medical Education.

Disclosure Declaration

It is the policy of CME Outfitters, LLC, to ensure independence, balance, objectivity, and scientific rigor and integrity in all of their CE activities. Faculty must disclose to the participants any relationships with commercial companies whose products or devices may be mentioned in faculty presentations, or with the commercial supporter of this CE activity. CME Outfitters, LLC, has evaluated, identified, and attempted to resolve any potential conflicts of interest through a rigorous content validation procedure, use of evidence-based data/research, and a multidisciplinary peer review process. The following information is for participant information only. It is not assumed that these relationships will have a negative impact on the presentations.

Dr. Petrylak reports that he receives grants from Ada Cap (Advanced Accelerator Applications); Agensys, Inc.; *Astellas Pharma US, Inc.; AstraZeneca; *Bayer; BioXcel Therapeutics, Inc.; Bristol-Myers Squibb Company; Clovis Oncology; Eisai Inc.; *Eli Lilly and Company; *Endocyte; Genentech, Inc.; *Innocrin Pharmaceuticals Inc.; MedImmune, Inc.; Medivation, Inc.; Merck & Co.; Mirati Therapeutics, Inc.; *Novarti; Pfizer Inc.; *Progenics Pharmaceuticals Inc.; Replimune Group Inc; Roche; *Sanofi-Aventis; and Seattle Genetics. He is a consultant for AdaCap (Advanced Accelerator Applications); Amgen Inc.; Astellas Pharma US, Inc.; AstraZeneca; Bayer; Bicycle Therapeutics; Boehringer Ingelheim; Bristol-Myers Squibb Company; Clovis Oncology; Eli Lilly and Company; Exelixis, Inc.; Incyte; Janssen Pharmaceuticals, Inc.; Mirati Therapeutics, Inc.; Monopteros Therapeutics, Inc.; Pfizer Inc.; Pharmacyclics; Roche; Seattle Genetics and UroGen Pharma, Inc. He held ownership interest/investmetns in Bellicum Pharmaceuticals, Inc. (sold 7/2020) and Tyme, Inc. (sold 10/2019).

*Denotes study trials that have terminated

Dr. Sonpavde reports that he receives research support from AstraZeneca; Immunomedics; QED Therapeutics, Inc.; and Sanofi. He is a consultant for AstraZeneca; Bicycle Therapeutics; Bristol-Myers Squibb Company; EMD Serono, Inc.; Exelixis, Inc.; Genentech, Inc.; Immunomedics; Janssen Pharmaceuticals, Inc.; Merck & Co.; Pfizer Inc.; Sanofi; and Seattle Genetics/Astellas Pharma US, Inc. He receives other financial or material support from AstraZeneca; Bladder Cancer Center of Excellence Steering Committee; Bristol-Myers Squibb Company; Debiopharm; Editor of Elsevier Practice Update; EMD Serono, Inc.; QED Therapeutics, Inc.; Seattle Genetics; and UpToDate, Inc.

Tony Graham, MD (peer reviewer) has no disclosures to report

Mae Ochoa, RPh (peer reviewer) has no disclosures to report

Susan Perry (planning committee) has no disclosures to report.

Jan Perez (planning committee) has no disclosures to report.

Sharon Tordoff (planning committee) has no disclosures to report.

Disclosures were obtained from the CME Outfitters, LLC staff: No disclosures to report.

CME Outfitters, LLC and the faculty do not endorse the use of any product outside of the FDA labeled indications. Medical professionals should not utilize the procedures, products, or diagnosis techniques discussed during this activity without evaluation of their patient for contraindications or dangers of use.

Obtaining Credit

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NOTE: Pharmacist CE Universal Activity Number, Enduring: 0376-0000-21-068-H01-P


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Treatment and Sequencing Strategies: Providing the Best Care for Patients with Metastatic Urothelial Carcinoma (mUC)
Event Date: 02/26/2021