Urothelial Carcinoma Treatment, 'Maintenance Therapy' Determines Quality of Life

[Financial News] Urothelial carcinoma, commonly known as bladder cancer, is considered a cancer with poor prognosis due to its rapid progression and frequent metastasis at the time of diagnosis.
According to the medical community on the 22nd, the existing standard treatment for stage 4 urothelial carcinoma patients was platinum-based chemotherapy, but there was a limitation in maintaining it for a long time due to accumulated toxicity in the body.
Even if patients experienced treatment effects for 2-3 months, the vicious cycle of disease worsening repeated due to the inability to continue treatment because of side effects.
What filled this gap was maintenance therapy using immunotherapy. It is an approach that maintains the treatment effect for a long time in patients whose disease is controlled by chemotherapy, while simultaneously improving the patient's quality of life and survival period.
In a global multicenter phase 3 clinical trial, it was confirmed that when the immunotherapy 'Avelumab' is administered as maintenance therapy, the median overall survival period reaches about 30 months.
Especially in the patient group treated with 'Gemcitabine+Cisplatin', it extended to 31 months, showing a clear difference compared to conventional chemotherapy alone. The rate of discontinuation due to toxicity was only around 10%, providing a foundation for patients to continue treatment for a long time.
Domestic medical professionals are also experiencing the same effect. Professor Kim In-ho of the Oncology Department at Seoul St. Mary's Hospital said, “Previously, patients could not endure long due to the toxicity of chemotherapy, but Avelumab maintenance therapy creates conditions for patients to continue to subsequent treatments.”
Professor Kim said, “It is significant in that it not only extends the survival period but also returns ‘living time’ to the patient.” 
The issue is treatment accessibility. In our country, health insurance coverage is recognized for Avelumab maintenance therapy, but the period is limited to 2 years.
After that, if patients want to continue treatment, they have to bear the cost of several million won per month. Professor Kim said, “The period of coverage recognition and the academic recommendation standards are separate,” adding, “In the actual medical field, there are many patients who want to continue treatment even if it is not covered by insurance.”
In metastatic urothelial cancer treatment, maintenance therapy is now becoming a necessity rather than an option. It is emerging as a decisive variable that determines not only the survival rate but also the quality of life of patients by allowing the ‘sparkling effect’ obtained from chemotherapy to be sustained for a long time.
Meanwhile, a representative immunotherapy containing Avelumab is Merck Korea's 'Bavencio'. Bavencio has been covered by health insurance as of August 1, 2023, as a first-line monotherapy maintenance therapy for adults with locally advanced or metastatic urothelial carcinoma.


vrdw88@fnnews.com Kang Jung-mo Reporter