Dr. Gupta on the Investigation of Cabozantinib Plus Avelumab in Metastatic Urothelial Cancer

Shilpa Gupta, MD, oncologist, Hematology and Medical Oncology, Cleveland Clinic, discusses the addition of cabozantinib (Cabometyx) to avelumab (Bavencio) in locally advanced or metastatic urothelial cancer.

The phase 3 MAIN-CAV trial (NCT05092958) is evaluating the combination of cabozantinib plus avelumab vs avelumab alone in patients with metastatic urothelial cancer.

Maintenance avelumab is currently the standard of care for patients with metastatic urothelial cancer who have not progressed following first-line treatment with platinum-based chemotherapy, Gupta says. The MAIN-CAV trial is investigating the intensification of maintenance avelumab with the VEGF inhibitor, cabozantinib, to evaluate if the combination can improve overall survival, Gupta explains.

Various subgroups within urothelial cancer do not derive as high of a benefit from maintenance avelumab alone, Gupta continues. This prompted the investigation of maintenance with cabozantinib plus avelumab, Gupta adds. The trial is currently active and accruing patients, Gupta concludes.