For clinicians treating patients with locally advanced or metastatic urothelial carcinoma, merely considering the best first-line therapy is not enough; they also consider what can be done to extend responses and subsequent therapies in the natural course of the disease. Recent evidence supports use of first-line switch maintenance therapy, or "line 1.5," with immunotherapeutic agents such as avelumab (Bavencio) that can lead to strong results in patients whose cancer responds to or remains stable following chemotherapy.
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