ESMO updates recommendations for bladder cancer

  • ESMO
  • 16 Jul 2020

  • curated by Deepa Koli
  • Univadis Clinical Summaries
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • The European Society for Medical Oncology (ESMO) has issued an update to its 2014 guidelines for the treatment of bladder cancer.
  • ESMO recommends maintenance avelumab in patients with metastatic disease.

Key updates

  • Chemotherapy remains standard first-line treatment in patients with advanced disease.
  • Platinum-containing combination chemotherapy is the standard of care for advanced or metastatic urothelial cancer.
  • Gemcitabine with cisplatin/carboplatin is most widely used.
  • Maintenance avelumab is recommended in patients who have not progressed on first-line platinum-based chemotherapy (4-6 cycles).
  • Maintenance avelumab improved OS vs best supportive care (HR, 0.69; 95% CI, 0.56-0.86).
  • The OS benefit was seen regardless of programmed death-ligand 1 (PD-L1) status, chemotherapy regimen given, and response to chemotherapy.
  • Treatment was initiated within 10 weeks of completion of chemotherapy and was given until disease progression.
  • Maintenance avelumab has not yet been approved by the European Medicines Agency.
  • First-line pembrolizumab or atezolizumab is recommended in PD-L1-positive patients.