(UroToday.com) There were approximately 81,400 new cases of bladder cancer diagnosed in 2020 and nearly 90% of these cases are urothelial carcinoma. Unresectable, locally advanced, or metastatic urothelial carcinoma is present in nearly 20% of all invasive urothelial carcinoma cases worldwide. Immune checkpoint inhibitors have demonstrated long-term responses with tolerable safety profiles in patients with metastatic urothelial carcinoma, including avelumab as first-line maintenance therapy for patients with advanced/metastatic urothelial carcinoma that have not progressed with platinum-containing chemotherapy. This treatment approach was recently approved in the US based on improved overall survival seen in the JAVELIN Bladder 100 trial.1 However, provider perspectives regarding first-line maintenance therapy in metastatic urothelial carcinoma have not been reported. At the GU ASCO 2021 annual meeting, Dr. Petros Grivas and colleagues presented results of their study of a quality analysis of oncology providers in the US with regards to their approaches to immune checkpoint inhibitor maintenance therapy for metastatic urothelial carcinoma.