First-line avelumab for patients with PD-L1-positive metastatic or locally advanced urothelial cancer who are unfit for cisplatin

•Cisplatin-based chemotherapy is the most recommended option for treatment of metastatic urothelial cancer (mUC).•Half of patients with mUC are considered cisplatin ineligible.•Anti-PD1/PD-L1 therapies have improved treatment of mUC and are considered an option for cisplatin-ineligible patients.•ARIES trial prospectively assessed activity and safety of the anti-PD-L1 avelumab in mUC patients not eligible to cisplatin.•The median OS was 10 months, the ORR was 24.0% and 8.5% had complete response; no safety concerns have been reported.