This study is being done to evaluate whether adding radiation therapy to the immunotherapy drug, atezolizumab can decrease the growth or spread of metastatic urothelial cancer.

Learn more about this trial in the below video.

This study also aims to determine if this approach is better or worse than the usual approach that most people get for urothelial cancer, which is chemotherapy or multiple other immunotherapy options, including pembrolizumab, nivolumab, and avelumab. These drugs have not been compared to one another for safety or effectiveness.

Atezolizumab is a type of immunotherapy called a monoclonal antibody that works to help the body’s immune system attack cancer and prevent tumor cells from growing and spreading. 

Atezolizumab is approved by the U.S. Food and Drug Administration (FDA) for urothelial cancer patients who are ineligible to receive platinum containing chemotherapy, but not for patients who have already received platinum containing chemotherapy. 

Stereotactic body radiation therapy (SBRT) is a type of radiation therapy that uses high energy x-rays to kill tumor cells and shrink tumors. This method uses special equipment to position a patient and precisely deliver radiation to tumors with high precision. This method may kill tumor cells with fewer doses over a shorter period and may cause less damage to normal tissue than conventional radiation therapy.

Participants in this study will be randomized to receive either atezolizumab alone or atezolizumab plus radiation. Randomization is like flipping a coin and there is a 50/50 chance of being assigned to either group.