Clarifying Timing of Immunotherapy for Advanced Bladder Cancer
Maintenance immunotherapy with avelumab (Bavencio) given immediately after first‑line platinum‑based chemotherapy significantly improves overall survival compared with supportive care alone until disease progression in patients with locally advanced or metastatic bladder cancer.
The JAVELIN Bladder 100 study randomized 700 patients with locally advanced or metastatic bladder cancer who had completed first‑line platinum‑based chemotherapy to receive either avelumab maintenance plus supportive care or supportive care alone. Maintenance avelumab produced a median overall survival of 21.3 months versus 14.1 months for supportive care alone, irrespective of PD‑L1 tumor expression, supporting the early initiation of checkpoint inhibition after chemotherapy.
This finding establishes maintenance immunotherapy as a superior strategy for extending survival in advanced bladder cancer and informs clinicians that delaying immunotherapy until disease progression may compromise patient outcomes.
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