Real-world efficacy and sequential therapy patterns after avelumab maintenance in metastatic urothelial carcinoma: a Brazilian multicenter retrospective cohort study.

Authors

Isabelle E Cohen, Helena F Bruzzi, Giulia C E S Gontijo, Maria Fernanda S S de Carvalho, Gabriela C K Lopes, Yasmim P Dias, Haonne S Abboud, Vinicius Freire, Daniel Herchenhorn

Published in

Cancer treatment and research communications. Volume 48. Pages 101368. Aug 15, 2026. Epub Aug 15, 2026.

Abstract

Avelumab is approved as maintenance therapy after platinum-based chemotherapy in metastatic urothelial carcinoma (mUC). Real-world evidence is needed to validate outcomes and define its role in the era of newly approved agents.
This retrospective study included patients with mUC from a Brazilian multicenter oncology network (2021-2026) who received ≥1 cycle of avelumab following chemotherapy. The primary endpoint was overall survival (OS), defined as the time from avelumab initiation to death from any cause. Secondary endpoints included progression-free survival (PFS), treatment-related toxicity, and subsequent therapies after progression. Survival outcomes were estimated using the Kaplan-Meier method.
Forty-six patients were included (63% male), with a median age of 71 years (range, 55-91). At a median follow-up of 24.4 months, 56.5% were alive, and 43.5% had died. Median treatment duration was 8.48 months, with a median of 19 cycles (range, 1-112). Median OS was not reached. Estimated OS rates at 12 and 36 months were 76.1% (95% CI, 65-89%) and 53% (95% CI, 40-71%), respectively. A PFS event occurred in 67.4% of patients, while 32.6% remained progression-free. After progression, 45.6% received second-line therapy, and 13% received third-line therapy. Median time to next treatment was 5.6 months. Grade 3-4 adverse events occurred in 26%, with no treatment-related deaths.
Avelumab maintenance demonstrated durable disease control, prolonged survival, and acceptable tolerability in an unselected real-world mUC population. Nearly half of the patients received subsequent therapy after progression.

PMID:
42603544
Bibliographic data and abstract were imported from PubMed on 16 Aug 2026.

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