## 3 Results
### Clinical Outcomes  
The median duration of avelumab 1 LM treatment was 3.9 months (Q1, Q3: 1.9, 7.2), with a median follow-up of 8.7 months (Q1, Q3: 4.5, 15.7) (Table 2). Among the 171 patients with a recorded response to avelumab 1 LM, the best response included 16 (9.4%) with a rwCR, 44 (25.7%) with a rwPR, and 44 (25.7%) with rwSD. ORR was 35.1% (95% CI: 28.0-42.7). Among the 214 patients, median rwOS and rwPFS from the start of avelumab 1 LM were 23.8 months (95% CI: 18.2--not estimable [NE]) and 5.1 months (95% CI: 4.1-7.0), respectively (Figure 4). Median TTD from avelumab 1 LM initiation was 4.9 months (95% CI: 4.2-6.5). Median TTNT from avelumab 1 LM initiation was 7.0 months (95% CI: 5.6-8.6).  
Of the 53 patients who received 2L EV after avelumab 1 LM, the median duration of 2L EV treatment was 4.2 months (Q1, Q3: 1.6, 6.3) (Table 2). Median rwOS and rwPFS from 2L EV initiation were 11.2 months (95% CI: 6.8--NE) and 4.9 months (95% CI: 3.9-8.8), respectively (Figure 5). Median TTD from 2L EV initiation was 4.7 months (95% CI: 4.2-8.5). Median TTNT from 2L EV initiation was 5.8 months (95% CI: 5.2-9.5).  
Figure 3: Treatment sequencing from 1 LM to 2L to 3L treatment regimens during the observation period. Abbreviations: 1 LM, first-line maintenance; 2L, second line; 3L, third line; ADC, antibody–drug conjugate; EV, enfortumab vedotin; IO, immuno-oncology.  
\begin{table}
\begin{tabular}{l l} \hline \hline
**Patients Treated with Avelumab 1 LM (n = 214)** \\ \hline
**Duration (months) of avelumab 1 LM treatment, median (Q1, Q3)** & 3.9 (1.9, 7.2) \\ \hline
**Median follow-up, months (Q1, Q3)** & 8.7 (4.5, 15.7) \\ \hline
**Best response to 1 LM *, n (\%)** \\ \hline rwCR & 16 (9.4) \\ \hline rwPR & 44 (25.7) \\ \hline rwSD & 44 (25.7) \\ \hline
**ORR, \% (95\% CI)** & 35.1 (28.0–42.7) \\ \hline
**Outcomes from 1 LM initiation, median (95\% CI), months** \\ \hline rwOS & 23.8 (18.2—NE) \\ \hline rwPPS & 5.1 (4.1–7.0) \\ \hline TTD & 4.9 (4.2–6.5) \\ \hline TTNT & 7.0 (5.6–8.6) \\ \hline
**Patients Treated with Subsequent 2L EV (n = 53)** \\ \hline
**Duration (months) of 2L EV treatment, median (Q1, Q3)** & 4.2 (1.6, 6.3) \\ \hline
**Outcomes from 2L EV initiation, median (95\% CI), months** \\ \hline rwOS & 11.2 (6.8—NE) \\ \hline rwPPS & 4.9 (3.9–8.8) \\ \hline TTD & 4.7 (4.2–8.5) \\ \hline TTNT & 5.8 (5.2–9.5) \\ \hline \hline \end{tabular}
\begin{tabular}{l l} \hline \hline
**Outcomes from 2L EV initiation, median (95\% CI), months** \\ \hline rwOS & 11.2 (6.8—NE) \\ \hline rwPPS & 4.9 (3.9–8.8) \\ \hline TTD & 4.7 (4.2–8.5) \\ \hline TTNT & 5.8 (5.2–9.5) \\ \hline \hline \end{tabular}
\begin{tabular}{l l} \hline \hline
**Abbreviations: 1 LM, first-line maintenance; 2L, second line; EV, enfortumab vedotin; NE, not estimable; ORR, objective response rate; QI, first quartile; Q3, third quartile; rwCR, real-world complete response; rwOS, real-world overall survival; rwPPS, real-world progression-free survival; rwPR, real-world partial response; rwSD, real-world stable disease; TTD, time to treatment discontinuation; TTNT, time to next treatment. * 171 patients had a recorded response to avelumab 1 LM.** \\ \hline \hline \end{tabular}
\end{table}
Table 2: Clinical outcomes associated with patients treated with avelumab 1 LM.  
Figure 4: rwOS and rwPFS from avelumab 1 LM initiation. Abbreviations: 1 LM, first-line maintenance; NE, not estimable; rwOS, real-world overall survival; rwPPS, real-world progression-free survival.