Prognostic factors in avelumab maintenance therapy for metastatic urothelial carcinoma

Kapar, Caner; Ozkan, Oguzcan; Eylemer Mocan, Eda; YASLIKAYA, ŞENDAĞ; Tatli, Ali; Akdag, Goncagul; DEMİR, HACER; Bilgetekin, Irem; Helvaci, Kaan; Selcukbiricik, Fatih; Kose, Fatih; SARI, MURAT; Erdem, Gokmen; Isleyen, Zehra; Arslan, Cagatay; Celik, Sinemis; EVRENSEL, TÜRKKAN; Durukan, Bekir; Kazaz, Seher; Ozturk, Banu; Celik, Halil; Ozen, Mirac; Erel, Pinar; Sanci, Pervin; Ergun, Yakup; Taban, Hakan; Kuzu, Omer; KILIÇ, BURCU; Arslan, Ahmet; Sakin, Abdullah; Araz, Murat; Okutur, Kerem; Akgul, Fahri; Mirili, Cem; Sevinc, Alper; Atalah, Fatih; Duzkopru, Yakup; Gulbagci, Burcu; Kandemir, Nurten; Kosku, Hakan; AYDIN, ESRA; Erdem, Dilek; Guliyev, Murad; Yilmaz, Mesut; Culha, Yasar; ŞAHİN, BERKSOY; GÜRSOY, PINAR; ERMAN, MUSTAFA; ÜRÜN, YÜKSEL; Tural, Deniz

doi:10.1080/1750743x.2026.2722548

Prognostic factors in avelumab maintenance therapy for metastatic urothelial carcinoma

Kapar C., Ozkan O., Eylemer Mocan E., YASLIKAYA Ş., Tatli A. M., Akdag G., ...More

IMMUNOTHERAPY, 2026 (SCI-Expanded, Scopus)

Publication Type: Article / Article
Publication Date: 2026
Doi Number: 10.1080/1750743x.2026.2722548
Journal Name: IMMUNOTHERAPY
Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, Chemical Abstracts Core, EMBASE, MEDLINE, Natural Science Collection (ProQuest), Biological Science Database (ProQuest), Health Research Premium Collection (ProQuest), Pharma Collection (ProQuest)
Istanbul University Affiliated: Yes

Abstract

Background: In the present study, we evaluated pretreatment prognostic factors for overall survival in patients with metastatic urothelial carcinoma who received maintenance avelumab within the Expanded-Access Program. Patients and methods: We retrospectively analyzed 132 patients with metastatic urothelial carcinoma who received at least one cycle of avelumab. Overall survival (OS) was estimated using the Kaplan-Meier method. Univariate analysis was performed to identify pretreatment prognostic factors associated with OS (p < 0.05), and significant variables were included in a multivariate Cox model. Results: Median age was 67 years (range, 43-84) and the bladder was the primary tumor site in 78% of patients. Visceral metastases were present in 62.5% of patients, and 32% had lymph node-only disease. ECOG >= 1 was observed in 59.1%, and 57% received cisplatin-based chemotherapy. The median follow-up was 24 months, the median OS was 23.8 months, and the 24-month OS rate was 47% (95% CI, 35%-55%). In univariate analysis, liver metastases, bone metastases, and hemoglobin < 10 g/dL were significantly associated with OS. In multivariate analysis, bone metastases (HR = 2.3; 95% CI 1.3-5; p = 0.008) and hemoglobin < 10 g/dL (HR = 2.6; 95% CI 1.2-4.1; p = 0.004) remained independent predictors of worse OS. Conclusions: Bone metastases and low hemoglobin are independent predictors of poor survival in patients receiving maintenance avelumab, supporting their role in risk stratification.