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Bladder Cancer
Center of Excellence
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In an effort to better serve our users, we have streamlined our content offering. As a result, we no longer publish new content or update existing content in Bladder Cancer. Visit the 'Content & Subscriptions' tab of your Settings page at any time to update your Dashboard or Newsletter Subscription preferences to continue to see news and information that interests you most.
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Guru Sonpavde
May 15, 2021
I would recommend avelumab switch-maintenance therapy now (within 4-10 weeks of last chemotherapy). Avelumab demonstrated improved overall survival (OS) as switch maintenance therapy in the JAVELIN-Bladder-100 phase III trial regardless of tumor PD-L1 expression in patients with metastatic urothelial carcinoma (mUC) who had stable or responding disease after 4-6 cycles of platinum-based first line chemotherapy (median OS 21.4 vs 14.3 months; HR, 0.69; 1-sided P = .0005). Switch maintenance avelumab also ensures early delivery of avelumab to a large fraction of patients when compared with the paradigm of administering a PD1/L1 inhibitor to those with progressive disease following a break from systemic therapy. The switch maintenance paradigm appeared to benefit patients regardless of tumor PD-L1 status, prior cisplatin vs carboplatin, quality of response (CR, PR, SD) and sites of metastasis (despite some trends, none of the sub-analyses were powered for definitive results). It is unclear if avelumab can be safely discontinued without compromising outcomes after a specific duration (especially in those with CR/PR) and a randomized ALLIANCE led study is evaluating this issue (NCT04637594) and should be supported.
Apr 19, 2024
Pending Moderator approval.
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Guru Sonpavde
May 15, 2021
Apr 19, 2024
Pending Moderator approval.