(UroToday.com) The current first-line standard of care therapy for advanced urothelial carcinoma patients with good performance status and kidney function is cisplatin-based chemotherapy. However, up to 50% of advanced urothelial carcinoma patients are not medically eligible for cisplatin therapy. Options, in this case, include carboplatin-based chemotherapy, or atezolizumab or pembrolizumab if patients have high levels of PD-L1 expression as assessed by the appropriate companion diagnostic test. In this presentation, Dr. Valderrama presented data from a multi-center phase 2 trial evaluating the efficacy of the anti-PD-L1 antibody avelumab in combination with carboplatin/gemcitabine chemotherapy as compared to carboplatin-based chemotherapy alone in patients who are ineligible to receive cisplatin.