Brain metastasis in a patient with metastatic urothelial carcinoma after 7 years of avelumab maintenance therapy: A case report

In the case of urothelial carcinoma, studies show improved survival in patients with advanced or metastatic disease by the addition of avelumab maintenance therapy after gemcitabine and platinum-based chemotherapy. The recommended follow-up does not include screening for brain metastasis. We describe a case of a male in his sixties who developed a brain metastasis from urothelial carcinoma, after 7 years of avelumab maintenance therapy. As the natural history of the disease changes with modern treatments, we need to monitor the sites of disease progression and be aware in case this traditionally rare site of progression becomes more common.