Maintenance Therapy in Locally Advanced or Metastatic Urothelial Carcinoma

Matthew Milowsky, MD


February 15, 2022

Urothelial carcinoma, which is a common cancer, traditionally has been difficult to treat in its advanced stages.

Despite being well established as a standard of care in locally advanced or metastatic disease, platinum-based chemotherapy is associated with a median overall survival of less than 15 months.

However, remarkable progress has been made in recent years, as discussed by Dr Matthew Milowsky from the University of North Carolina School of Medicine.

He explains that there has been a paradigm shift in patient management in advanced urothelial carcinoma with the introduction of newer treatments for maintenance therapy.

Immune checkpoint inhibitors, as shown in the JAVELIN Bladder 100 trial, are associated with meaningful improvements in overall survival and have a manageable safety profile.

Excitement has also been generated by the recent US Food and Drug Administration approval of two antibody-drug conjugates: enfortumab vedotin and sacituzumab govitecan.

As Dr Milowsky reports, these agents have achieved impressive results in pretreated patients, including those ineligible for chemotherapy and those who have received immunotherapy.


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