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Bladder Cancer — SCE Medical Oncology MCQ

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HardUrological CancersBladder CancerSCE Medical Oncology

A patient with metastatic urothelial carcinoma has stable disease after six cycles of gemcitabine-carboplatin and remains ECOG 1. There is no immune-therapy contraindication. What maintenance plan is NICE recommended?

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Correct answer: D — Start avelumab maintenance, capped at 5 uninterrupted years

TA788 applies when locally advanced or metastatic urothelial cancer has not progressed after platinum-based chemotherapy; stable disease therefore qualifies alongside response. Avelumab is stopped after 5 uninterrupted years or earlier progression. Continuing platinum chemotherapy indefinitely adds cumulative toxicity, and the other agents are not the TA788 maintenance intervention.

Reference: NICE TA788 avelumab maintenance after platinum-based chemotherapy for urothelial cancer (Published May 2022): https://www.nice.org.uk/guidance/ta788/chapter/1-Recommendations