Page 4 - CUA-BCC _Brochure 2022

If you receive cisplatin or carboplatin, it will probably be combined with other chemotherapy drugs to make it
more effective. A drug called gemcitabine is most commonly used with either cisplatin or carboplatin, but you may
receive other drugs such as docetaxel or paclitaxel.

What immunotherapy drugs are there?

The immunotherapy drugs most often recommended for MUC treatment are called immune checkpoint inhibitors.
They include pembrolizumab, durvalumab, atezolizumab and avelumab.

What is maintenance therapy?
Maintenance therapy is treatment that is given to patients whose cancer hasn’t progressed after chemotherapy
(got better or didn’t get worse). Its purpose is to provide a different type of treatment to cancer cells that were not
destroyed by the initial chemotherapy.

In Canada, an immune checkpoint inhibitor called avelumab can be used as maintenance therapy after cisplatin or
carboplatin chemotherapy in patients whose cancer didn’t progress with chemotherapy.

How long will my treatment last?

It depends on the kind of treatment you are receiving. Chemotherapy is usually done for four to six “cycles” where a
cycle takes three or four weeks. You will only be given chemotherapy on one to two days per cycle.

Immunotherapy is given as one dose every two to four weeks and can be continued as long as your cancer isn’t
getting worse and you aren’t having troublesome side effects.

Maintenance therapy with the specific agent called avelumab is given once every two weeks and can also be
continued as long as your cancer isn’t getting worse and you aren’t having troublesome side effects.

Targeted therapy with an approved drug named erdafitinib is given every day as tablets to take orally. It is also
continued as long as your cancer isn’t getting worse and you aren’t having troublesome side effects. It is only useful if
your cancer is found to have a mutation in a gene called “fibroblast growth factor receptor or FGFR”. This mutation is
found in approximately 10-15% of all metastatic urothelial cancers. More research is being done to better understand
the role of FGFR.

The antibody-drug conjugate approved in Canada is called enfortumab-vedotin and is given on three days of a
four-week cycle, and is also continued as long as your cancer isn’t getting worse and you aren’t having
troublesome side effects.