Maintenance avelumab for metastatic urothelial cancer: a new standard of care.

The Javelin Bladder 100 trial was the first trial to establish the role of switch maintenance therapy in patients with metastatic urothelial cancer using avelumab, a PD-L1 inhibitor, for patients who achieve complete response, partial response, or stable disease to standard chemotherapy of 4-6 cycles with gemcitabine and cisplatin or carboplatin. Improvement in parameters of overall survival in both the overall population and the PD-L1 positive population was seen and has led to the US FDA approval of avelumab as maintenance therapy for metastatic urothelial cancer. This manuscript further discusses the highlights of the study, patient population, and considerations regarding choice of therapy for maintenance avelumab.