Maintenance Therapy in Metastatic Urothelial Carcinoma: Integrating Current Treatment Options into Practice

This activity is part of a series


Daniel P. Petrylak, MD
Professor of Medicine (Medical Oncology) and Urology Yale School of Medicine
Co-Director, Signal Transduction Research Program Smilow Cancer Center New Haven, CT
Daniel P. Petrylak, MD

Daniel P. Petrylak, MD, was appointed to lead the genitourinary cancers medical oncology team at Smilow Cancer Hospital as Director of the prostate cancer research group, Professor, and Co- Director of the Signal Transduction Research Program. He joined Yale from New York-Presbyterian Hospital/Columbia University Medical Center, where he served as a Professor of Medicine and began his appointment in September 2012. He is a member of the American Association for Cancer Research, American Society for Clinical Oncology, American College of Physicians, American Association for the Advancement of Science, American Urological Association, and the Southwest Oncology Group. Dr. Petrylak currently serves as the Principal Investigator or Co-Principal Investigator on nine Southwest Oncology Group (SWOG) clinical trials for genitourinary cancers and has led the advanced bladder cancer subcommittee for SWOG since 1995. Additionally, he has led multiple national and international studies in prostate and bladder cancer.

Dr. Petrylak’s research interests span both prostate and bladder cancer. He led an investigator-initiated trial of docetaxel and estramustine in castration-resistant prostate cancer. The results of this study supported a phase III trial of this combination in SWOG led by Dr. Petrylak, which in turn, supported the FDA approval of docetaxel for castration-resistant prostate cancer. This was one of the first two trials to demonstrate a survival benefit in this state of disease. Dr. Petrylak has also been instrumental in the development of immunotherapy and targeted therapies for refractory bladder cancer. His work with enfortumab vedotin has supported the accelerated approval of this drug.

Dr. Petrylak received his undergraduate degree from Columbia College and his medical degree from Case Western University School of Medicine. He completed his internship and residency at Albert Einstein College of Medicine and his fellowship in medical oncology at Memorial Sloan-Kettering Cancer Center. Dr. Petrylak has authored more than 140 peer-reviewed articles and book chapters on prostate and bladder cancer research outcomes.

Guru Sonpavde, MD
Bladder Cancer Director Dana Farber Cancer Institute
Associate Professor of Medicine Harvard Medical School Boston, MA
Guru Sonpavde, MD

Guru P. Sonpavde, MD, is a medical oncologist and the Bladder Cancer Director at the Dana Farber Cancer Institute as well as Associate Professor of Medicine at Harvard Medical School. At Dana-Farber, he leads multiple cutting-edge clinical trials studying novel immunotherapy and targeted drugs to cure bladder cancer. He is the national or international Principal Investigator of multiple clinical trials for patients with bladder cancer. Dr. Sonpavde has also led translational projects and developed prognostic classifications and clinical endpoints focused on bladder cancer. He is a member of Southwest Oncology Group (SWOG) and Bladder Cancer Task Force of the U.S. NCI GU Steering Committee.

Statement of Need

Platinum-based chemotherapy is standard of care for first-line (1L) treatment of advanced metastatic urothelial carcinoma (mUC). However, despite objective response in 40% – 50% and disease control in 75% – 80%, response is not durable, and most patients will have disease proression within ~9 months. Maintenance therapy can reinforce and sustain the favorable clinical state achieved with chemotherapy, and can be a continuation of an agent as part of the combination induction regimen or as sequential treatment with new agents.

The first episode of this CMEOCast podcast series on practice-changing treatment advances in mUC focuses on examining current 1L treatment options, including maintenance therapy to optimize patient outcomes in mUC.

Learning Objectives

At the end of this CME/CE activity, participants should be able to examine current 1L treatment options, including maintenance therapy, for mUC and integrate as appropriate into practice.

The following learning objectives pertain only to those requesting CNE or CPE credit: Describe current 1L treatment options, including maintenance therapy, for mUC used in clinical practice.

Financial Support

Supported by an educational grant from Pfizer Inc. and EMD Serono, Inc.

Target Audience

Oncologists, PAs, nurse practitioners, nurses, and pharmacists

Credit Information

Pharmacists (ACPE)

This application-based activity is approved for 1.0 contact hour (0.10 CEUs) of continuing pharmacy credit. Jump to Activity UAN.

Physicians (ACCME)

CME Outfitters, LLC, is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. CME Outfitters, LLC, designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 MOC point in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

Royal College MOC

Through an agreement between the Accreditation Council for Continuing Medical Education and the Royal College of Physicians and Surgeons of Canada, medical practitioners participating in the Royal College MOC Program may record completion of accredited activities registered under the ACCME’s “CME in Support of MOC” program in Section 3 of the Royal College’s MOC Program.

Note to Nurse Practitioners

Nurse Practitioners can apply for AMA PRA Category 1 Credit through the American Academy of Nurse Practitioners (AANP). AANP will accept AMA PRA Category 1 Credit  from organizations accredited by the Accreditation Council for Continuing Medical Education. Nurse practitioners can also apply for credit through their state boards.

MIPS Improvement Activity

This activity counts towards MIPS Improvement Activity requirements under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Clinicians should submit their improvement activities by attestation via the CMS Quality Payment Program website.

Note to Physician Assistants

AAPA accepts certificates of participation for educational activities certified for AMA PRA Category 1 Credit  from organizations accredited by the Accreditation Council for Continuing Medical Education.

Disclosure Declaration

It is the policy of CME Outfitters, LLC, to ensure independence, balance, objectivity, and scientific rigor and integrity in all of their CE activities. Faculty must disclose to the participants any relationships with commercial companies whose products or devices may be mentioned in faculty presentations, or with the commercial supporter of this CE activity. CME Outfitters, LLC, has evaluated, identified, and attempted to resolve any potential conflicts of interest through a rigorous content validation procedure, use of evidence-based data/research, and a multidisciplinary peer review process. The following information is for participant information only. It is not assumed that these relationships will have a negative impact on the presentations.

Dr. Petrylak reports that he receives grants from Ada Cap (Advanced Accelerator Applications); Agensys, Inc.; * Astellas Pharma US, Inc.; AstraZeneca; *Bayer; BioXcel Therapeutics, Inc.; Bristol-Myers Squibb Company; Clovis Oncology; Eisai Inc.; * Eli Lilly and Company; *Endocyte; Genentech, Inc.; * Innocrin Pharmaceuticals Inc.; MedImmune, Inc.; Medivation, Inc.; Merck & Co.; Mirati Therapeutics, Inc.; *Novarti; Pfizer Inc.; * Progenics Pharmaceuticals Inc.; Replimune Group Inc; Roche; *Sanofi-Aventis; and Seattle Genetics. He is a consultant for AdaCap (Advanced Accelerator Applications); Amgen Inc.; Astellas Pharma US, Inc.; AstraZeneca; Bayer; Bicycle Therapeutics; Boehringer Ingelheim; Bristol-Myers Squibb Company; Clovis Oncology; Eli Lilly and Company; Exelixis, Inc.; Incyte; Janssen Pharmaceuticals, Inc.; Mirati Therapeutics, Inc.; Monopteros Therapeutics, Inc.; Pfizer Inc.; Pharmacyclics; Roche; Seattle Genetics and UroGen Pharma, Inc. He held ownership interest/investments in Bellicum Pharmaceuticals, Inc. (sold 7/2020) and Tyme, Inc. (sold 10/2019).

*Denotes study trials that have terminated

Dr. Sonpavde reports that he receives research support from AstraZeneca; Immunomedics; QED Therapeutics, Inc.; and Sanofi. He is a consultant for AstraZeneca; Bicycle Therapeutics; Bristol-Myers Squibb Company; EMD Serono, Inc.; Exelixis, Inc.; Genentech, Inc.; Immunomedics; Janssen Pharmaceuticals, Inc.; Merck & Co.; Pfizer Inc.; Sanofi; and Seattle Genetics/Astellas Pharma US, Inc. He receives other financial or material support from AstraZeneca; Bladder Cancer Center of Excellence Steering Committee; Bristol-Myers Squibb Company; Debiopharm; Editor of Elsevier Practice Update; EMD Serono, Inc.; QED Therapeutics, Inc.; Seattle Genetics; and UpToDate, Inc.

Tony Graham, MD (peer reviewer) has no disclosures to report

Mae Ochoa, RPh (peer reviewer) has no disclosures to report

Susan Perry (planning committee) has no disclosures to report.

Jan Perez (planning committee) has no disclosures to report.

Sharon Tordoff (planning committee) has no disclosures to report.

Disclosures were obtained from the CME Outfitters, LLC, staff: No disclosures to report.

Faculty of this CE activity may include discussions of products or devices that are not currently labeled for use by the FDA. The faculty have been informed of their responsibility to disclose to the audience if they will be discussing off-label or investigational uses (any uses not approved by the FDA) of products or devices.

Obtaining Credits

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NOTE: Pharmacist CE Universal Activity Number, Enduring: JA0007185-0000-21-095-H01-P


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Maintenance Therapy in Metastatic Urothelial Carcinoma: Integrating Current Treatment Options into Practice
Event Date: 02/26/2021