(UroToday.com) Multiple anti-PD-L1 therapies have been approved for use in 2nd line in patients with advanced urothelial carcinoma (UC), including pembrolizumab. The current standard of care first-line therapy for advanced UC is cisplatin-based chemotherapy. Avelumab is recommended as maintenance therapy in patients who do not progress on first-line platinum-based chemotherapy. Pembrolizumab and atezolizumab are recommended as first-line therapy for patients with PD-L1-expressing tumors, ineligible for cisplatin-based chemotherapy, and patients who are ineligible for any platinum agent, regardless of PD-L1 status in the US.