Development and landscape of maintenance therapy after first-line treatment of advanced or metastatic urothelial carcinoma

TL;DR

This paper reviews the development of avelumab as maintenance therapy for advanced urothelial carcinoma and explores future treatment options.

Contribution

The paper provides a comprehensive review of avelumab-based maintenance therapy and its implications for future treatment strategies.

Findings

Avelumab was established as effective maintenance therapy after first-line chemotherapy in the JAVELIN Bladder100 study.

New first-line treatment options are influencing future directions for maintenance therapy in advanced urothelial carcinoma.

Maintenance therapy is crucial for improving overall survival in patients with metastatic urothelial carcinoma.

Abstract

Overall survival (OS) in patients with advanced or metastatic urothelial carcinoma (UC) is not optimistic. For a long time, the standard platinum-based chemotherapy has been one of the preferred treatment strategies. Despite the high initial objective response rate (ORR) to first-line chemotherapy in patients with metastatic UC, the rate of achieving complete response (CR) is low, and most patients will relapse within one year after first-line treatment. To further improve the OS of patients with metastatic UC, the success of the CheckMate901 and EV302 studies has brought new therapeutic options for the first-line treatment of these patients. Maintenance or consolidation therapy after first-line treatment is also important to improve the OS of patients with advanced UC. Maintenance therapy after first-line treatment of metastatic UC has undergone a long period of development until the success of the JAVELIN Bladder100 study. For the first time, this study established the application of avelumab as maintenance therapy after first-line platinum-containing chemotherapy. The aim of this paper is to review the development process of avelumab-based maintenance therapy after first-line treatment of advanced or metastatic UC and explore future options for maintenance therapy in patients with advanced or metastatic UC in the light of new first-line treatment options.

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