Urothelial transitional cell cancer (uTCC) is a type of cancer that typically starts in the cells that line the inside of the urinary system: the bladder, parts of the kidney, and associated structures such as the ureters which are the tubes connecting the kidneys to the bladder. People with “advanced or metastatic urothelial cancer” have cancer which has spread beyond the region of the urinary system, typically to lymph nodes, the wall of the abdomen or pelvis, bones or other organs. Chemotherapy is commonly used in this situation. The two commonest types of chemotherapy used initially (“first-line”) use the drugs Gemcitabine and Cisplatin (referred to as GC), or methotrexate, vinblastine, doxorubicin and cisplatin (MVAC). These are called “platinum-based” treatments. Some patients need further chemotherapy if the cancer comes back or worsens. There is no good evidence showing a benefit of one type of chemotherapy over any other in this “second-line” setting. Chemotherapy drugs of a type called Taxanes have commonly been used as a second line treatment. This family of chemotherapy drugs include Nab-Paclitaxel and Paclitaxel.

This study has been designed to look at whether Nab-Paclitaxel improves survival and is less toxic with improved quality of life compared with Paclitaxel in people with advanced or metastatic urothelial cancer, in the setting where the cancer has grown or come back during or within 12 months of completion of platinum based chemotherapy.