Treating mUC With Preexisting Neuropathy

Karine Tawagi, MD, of the University of Illinois College of Medicine, explains the treatment options available for patients with metastatic bladder cancer who already have neuropathy.

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Dr. Tawagi: Clinicians may just go to carboplatin-based chemotherapy, but there still might be a risk of some neuropathy, though less so than with either cisplatin or enfortumab vedotin. That might be a challenging situation, specifically if someone has really bad neuropathy. If it was manageable, maybe clinicians could consider starting at a lower dose of EV/pembrolizumab. Again, not based off of any data, but for patients that are more frail or elderly, some providers are suggesting maybe starting at the 1 mg/kg dose rather than the 1.25 mg/kg dose.

View her continued comments.