(UroToday.com) Dr. Enrique Grande from Madrid, Spain provided a state-of-the-art lecture at the European Association of Urology (EAU) 2021 annual meeting’s advanced bladder cancer session discussing immunotherapy in the first-line setting for metastatic bladder cancer. Dr. Grande notes that over the last several years, it seems that immunotherapy covers the entire spectrum of first-line treatment of metastatic bladder cancer. In cisplatin eligible patients, avelumab maintenance therapy is standard of care for those that respond to first-line cisplatin-based chemotherapy. For cisplatin ineligible patients, those that respond to first-line carboplatin-based chemotherapy should also receive avelumab maintenance therapy. Additionally, for PD-L1+ cisplatin ineligible patients, they can also receive first-line single-agent atezolizumab or pembrolizumab therapy: