{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T06:01:15Z","timestamp":1781157675008,"version":"3.54.1"},"reference-count":18,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Avelumab maintenance therapy is an established therapeutic approach for patients with advanced urothelial carcinoma (UC) whose disease has not progressed after first-line platinum-based chemotherapy. However, evidence on its effectiveness and safety in elderly patients remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicenter retro-prospective Italian study included 251 patients with advanced UC who received avelumab maintenance between 2021 and 2023. Outcomes were compared between patients aged \u226575 and &amp;lt;75 years. Primary endpoints were progression-free survival (PFS) and overall survival (OS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 96 elderly and 155 younger patients, median PFS was 7.2 months (95% CI, 4.9\u201317.5) and 6.7 months (95% CI, 4.9\u20139.3), respectively (p = 0.547), while median OS was 28.1 months (95% CI, 17.3\u201342.1) versus 18.5 months (95% CI, 12.0\u201338.6) (p = 0.238). Immune-related adverse events were infrequent and generally comparable across age groups. In multivariable analyses, lung metastases independently predicted worse OS in elderly patients, whereas bone metastases and concomitant corticosteroid therapy were adverse prognostic factors in younger patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Avelumab maintenance demonstrated similar efficacy and safety in elderly and younger patients, supporting its use regardless of age. In the evolving therapeutic landscape of advanced UC, this treatment strategy remains a relevant and practical option, particularly for elderly or comorbid patients who may not be candidates for more intensive first-line combinations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1818239","type":"journal-article","created":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T05:47:15Z","timestamp":1781156835000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness and safety of avelumab maintenance in patients aged \u226575 years with advanced urothelial cancer: a sub-analysis of the meet-URO 25 (MALVA) study"],"prefix":"10.3389","volume":"17","author":[{"given":"Giandomenico","family":"Roviello","sequence":"first","affiliation":[{"name":"Department of Health Sciences, Section of Clinical Pharmacology and Oncology, University of Florence","place":["Florence, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabetta","family":"Gambale","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine, University of Florence","place":["Florence, Italy"]},{"name":"Careggi University Hospital, Clinical Oncology","place":["Florence, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"De Gennaro Aquino","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine, University of Florence","place":["Florence, Italy"]},{"name":"Careggi University Hospital, Clinical Oncology","place":["Florence, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Maruzzo","sequence":"additional","affiliation":[{"name":"Oncology 3 Unit, Department of Oncology, Istituto Oncologico Veneto IOV - 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