Prior work has shown that UC tumours with CDKN2A alterations are associated with worse cancer-specific survival compared with other UCs.33,34 However, the median PFS in our study of 1.9 months is in keeping with other studies in this patient population and reflects the inherent aggressive nature and difficulty in treating metastatic UC after platinum-based chemotherapy. This evidence concerns the gene CDKN2A and neoplasm.