Expanding our RANGE of options.

Going platinum multiple times looks better on R. Kelly than it does on bladder cancer. The long-time standard of platinum-based chemo regimens can be frustrating given relentless frequent progression among those with advanced or metastatic disease. The RANGE trial published this month in Lancet adds to the growing list of new agents that are now expanding treatment options for patients with advanced bladder cancer. Patients who progressed after platinum-based chemotherapy were randomized to docetaxel (a standard salvage chemo) +/- ramucirumab (a VEGFR-2 antagonist). The addition of ramucirumab was associated with a significantly minimal improvement in progression free survival from 2.7 -> 4 months. Good, but not great, news. But with the RANGE trial coming at the heels of another similarly-designed KEYNOTE-045 trial earlier this year showing a 3-month overall survival advantage with pembrolizumab, things are looking good for our once wimpy bladder cancer armamentarium….which we can only hope will soon upgrade its status from platinum to diamond.