What adjuvant therapy would you recommend for a cisplatin and IO ineligible patient with node positive urothelial carcinoma with mixed histology?

This is a difficult situation and I agree that there is evidence for adjuvant carboplatin-gemcitabine in cisplatin-ineligible patients with high-risk upper tract urothelial carcinoma, although benefit appeared more modest compared to cisplatin-gemcitabine (POUT trial). It is reasonable to extrapolat...

Certainly node positive UC has poor prognosis and high likelihood of recurrence. If this patient has not previously received neoadjuvant chemotherapy, I would offer a carboplatin-based chemotherapy regimen in the adjuvant setting (usually carboplatin/gemcitabine).

In addition, I would send off the c...