Liu Zengguang, Cong Xiaofeng, Chen Chen, Yin Jiaxin, Liu Ziling
Department of Cancer Center, The First Hospital of Jilin University, Changchun, China.
Front Immunol. 2025 Jul 31;16:1541213. doi: 10.3389/fimmu.2025.1541213. eCollection 2025.
Overall survival (OS) in patients with advanced or metastatic urothelial carcinoma (UC) is not optimistic. For a long time, the standard platinum-based chemotherapy has been one of the preferred treatment strategies. Despite the high initial objective response rate (ORR) to first-line chemotherapy in patients with metastatic UC, the rate of achieving complete response (CR) is low, and most patients will relapse within one year after first-line treatment. To further improve the OS of patients with metastatic UC, the success of the CheckMate901 and EV302 studies has brought new therapeutic options for the first-line treatment of these patients. Maintenance or consolidation therapy after first-line treatment is also important to improve the OS of patients with advanced UC. Maintenance therapy after first-line treatment of metastatic UC has undergone a long period of development until the success of the JAVELIN Bladder100 study. For the first time, this study established the application of avelumab as maintenance therapy after first-line platinum-containing chemotherapy. The aim of this paper is to review the development process of avelumab-based maintenance therapy after first-line treatment of advanced or metastatic UC and explore future options for maintenance therapy in patients with advanced or metastatic UC in the light of new first-line treatment options.
晚期或转移性尿路上皮癌（UC）患者的总生存期（OS）并不乐观。长期以来，标准的铂类化疗一直是首选治疗策略之一。尽管转移性UC患者对一线化疗的初始客观缓解率（ORR）较高，但完全缓解（CR）率较低，且大多数患者在一线治疗后一年内会复发。为进一步提高转移性UC患者的OS，CheckMate901和EV302研究的成功为这些患者的一线治疗带来了新的治疗选择。一线治疗后的维持或巩固治疗对于提高晚期UC患者的OS也很重要。转移性UC一线治疗后的维持治疗经历了很长时间的发展，直到JAVELIN Bladder100研究取得成功。该研究首次确立了阿维鲁单抗作为含铂一线化疗后维持治疗的应用。本文旨在回顾晚期或转移性UC一线治疗后基于阿维鲁单抗的维持治疗的发展过程，并根据新的一线治疗选择探索晚期或转移性UC患者维持治疗的未来选择。
