Real-World Clinical Outcomes with First-Line Systemic Treatment and Avelumab Maintenance in US Patients with Locally Advanced or Metastatic Urothelial Carcinoma: The SPEAR Bladder-II Study

Real-World Clinical Outcomes with First-Line Systemic Treatment and Avelumab Maintenance in US Patients with Locally Advanced or Metastatic Urothelial Carcinoma: The SPEAR Bladder-II Study

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Avelumab first-line maintenance (1LM) is approved for patients with locally advanced or metastatic urothelial carcinoma (la/mUC) who do not have disease progression after platinum-based chemotherapy (PBC).This retrospective study describes real-world treatment patterns and clinical outcomes in patients with la/mUC who initiated first-line (1L) systemic treatments, including avelumab 1LM, within iKnowMed, oas ba?adores the US community oncology electronic health records database, between 1 December 2019 and 30 November 2023 and followed through 28 February 2024.In total, 1658 patients with la/mUC initiated 1L treatment: immuno-oncology (IO) monotherapy (41.2%), PBC only (32.4%), PBC followed by avelumab 1LM (11.

2%), and other treatments (15.1%).The median OS (95% CI) from the start of 1L treatment was 20.4 (13.8, 30.

0), 11.0 (8.5, 14.5), and 14.6 (12.

6, 17.3) months for cisplatin-based only, carboplatin-based only, and IO monotherapy, respectively.Among the overall population, 36.1% and 11.8% of patients received second-line (2L) and third-line treatment, respectively.

The median (95% CI) OS from the start of avelumab 1LM was 18.5 (13.8, 23.8) months.After discontinuation of avelumab 1LM, 43.

5% received 2L treatment, and 59.3% of those received enfortumab vedotin (EV); the median (95% CI) OS from start of 2L tasoliesi EV was 12.7 (7.2, 16.5) months.

Survival outcomes among patients treated with avelumab 1LM and 2L EV are consistent with respective clinical trials and other real-world studies.