ESMO 2025: De-Escalated Chemotherapy Prior to Maintenance Avelumab Is Effective in Advanced Urothelial Cancer

Fewer chemotherapy cycles may be enough for patients with metastatic urothelial carcinoma. In the phase II DISCUS trial, presented by Enrique Grande, MD, PhD, from Quirónsalud Madrid at ESMO 2025, three cycles of platinum-based chemotherapy before avelumab maintenance led to improved quality of life without compromising survival compared with six cycles. The findings support a move toward de-escalated treatment strategies that reduce toxicity while preserving efficacy.