Cabozantinib in Combination With Enfortumab Vedotin for Locally Advanced or Metastatic Urothelial Cancer

This trial tests the combination of cabozantinib (a drug that blocks tumor blood vessel growth) with enfortumab vedotin (an antibody that delivers chemotherapy directly to cancer cells) in patients with bladder and urinary tract cancer that has spread or cannot be surgically removed and has already received prior immunotherapy and/or platinum chemotherapy. **You may be eligible if...** - You are 18 or older with confirmed urothelial carcinoma (cancer of the bladder, ureter, renal pelvis, or urethra) that has spread - You have previously received an immunotherapy drug (PD-1 or PD-L1 inhibitor) - You have had prior platinum-based chemotherapy or are ineligible for it - You have at least one measurable tumor on imaging - Your overall health score is 2 or below (ECOG), and your blood counts and organ function meet the study requirements **You may NOT be eligible if...** - You have not had prior immunotherapy - You have significant unresolved side effects from prior treatment - You do not have tumor tissue available for testing - You have serious heart, kidney, or liver problems Talk to your doctor to see if this trial is right for you.