The phase II DISCUS trial investigated the effectiveness of 3 versus 6 cycles of platinum-based chemotherapy followed by avelumab maintenance in advanced urothelial cancer patients. Results indicated that both regimens had similar overall survival of 18.9 months, but the 3-cycle regimen was associated with better quality of life. The 3-cycle regimen also resulted in fewer serious adverse events and treatment discontinuations, making it a viable option for improving patient quality of life without compromising survival outcomes.
Study
|
Randomized phase II trial [DISCUS] |
| Advanced or metastatic urothelial cancer |
| 3 cycles (n=133) vs 6 cycles (n=134) of platinum-gemcitabine chemotherapy followed by avelumab
|
Efficacy
|
ORR: 24% vs 27% |
| Median OS: 18.9 months vs 18.9 months (HR 1.15 [0.72-1.86]) |
| Median PFS: 8.0 months vs 9.0 months (HR 1.05 [0.73-1.53])
|
Safety
|
Grade >=3 AE: Neutropenia (11.9% vs 15.7%), Serious AEs (35% vs 37%) |
| Treatment discontinuation (3C: 8% chemotherapy, 2% avelumab; 6C: 13% chemotherapy, 4% avelumab)
|
Ann Oncol. Published online 2025
http://doi.org/10.1016/j.annonc.2025.10.011
Reviewed by Ulas D. Bayraktar, MD on Nov 17, 2025
