Would you use maintenance avelumab for a patient with metastatic urothelial carcinoma who progressed on first-line pembrolizumab, then had stable disease after at least four cycles of second-line carboplatin plus gemcitabine?

Topics: Genitourinary Cancers • Bladder Cancer • Medical Oncology • NCI-CCC Tumor Board Question • UCSF • NCI-CCC GU Tumor Board Question

Would it change your decision if they had progressed on a first-line trial with cisplatin followed by pembrolizumab plus enfortumab vedotin maintenance?

Answer from: Medical Oncologist at Academic Institution

Great question. I would suggest that if the patient progressed on prior PD-1/PD-L1 inhibition, the standard would be observation (as challenging as that may be in clinical practice!). At progression, would probably not offer checkpoint inhibitor and would instead favor novel therapies like enfortuma...

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Medical Oncologist at University of California San Francisco
Thank you for a thoughtful response, Dr. @Sumanta ...

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