What is your preferred treatment for a patient with refractory metastatic upper tract urothelial carcinoma previously treated with adjuvant gemcitabine/cisplatin, enfortumab vedotin + pembrolizumab, docetaxel and sacituzumab govitecan?

HER2 negative by IHC, and no FGFR alterations. Are there other SOC options or trials that you recommend?