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Uptake of maintenance immunotherapy and changes in upstream treatment selection among patients with urothelial cancer

April 25, 2023


In July 2020, the FDA approved avelumab, an immune checkpoint inhibitor (ICI) used for the maintenance treatment of advanced urothelial cancer that has not progressed with first-line platinum-containing chemotherapy. 

Avelumab is the first maintenance therapy available that has been shown to improve survival rates for those with urothelial cancer. This advancement may lead to providers considering different options for initial treatments, such as choosing between first-line platinum chemotherapy or first-line ICI (pembrolizumab or atezolizumab). 

In this study, researchers from the University of Pennsylvania, Merck, and Flatiron Health used real-world data to analyze how avelumab has been used in clinical practice to determine if clinicians have an increasing preference for alternative treatment options for their patients.

Why this matters

Despite their rapid adoption as first-line treatments, the limited use of immunotherapy drugs as maintenance therapy is noteworthy. This contrast may include a lack of awareness among clinicians regarding the benefits of maintenance immunotherapy or patient reluctance to undergo long-term treatment after responding to initial chemotherapy. 

The results of this study can raise awareness about the effects of immunotherapy drugs like avelumab and provide insights into how the introduction of new medications is transforming the treatment landscape and improving patient outcomes.

Read the research