What chemotherapy regimen do you use for de novo metastatic squamous cell carcinoma of penile urethra?

Challenging cancer and prognosis; therapy with palliative intent (Nutrition and Palliative Care consults can help regardless of which therapy to use); in pure SCC of penile urethra, would likely consider platinum/gemcitabine or platinum/taxane as 1L therapy as a conventional chemo regimen with periodic imaging for restaging. While EV/pembro is the preferred SOC in metastatic urothelial Ca and seems an attractive regimen to at least consider in this case, we do not know much about Nectin4 expression in pure SCC of penile urethra, and such patients would have been excluded from EV-103 and EV-302 trials; however, it could be a consideration if it can get authorized. Checkpoint inhibitors, other conventional cytotoxic agents, and clinical trial...