Data from a phase II trial reveal the superiority of vinflunine as maintenance chemotherapy, relative to best-supportive care until disease progression, in patients with metastatic transitional-cell carcinoma of the urothelial tract following 4–6 cycles of cisplatin and gemcitabine. A total of 66% of patients in the vinflunine group had disease progression compared with 84% of patients who received best-supportive care after a median follow-up duration of 15.6 months, with a median progression-free survival duration of 6.5 months versus 4.2 months (P = 0.031). A total of 18% of patients in the vinflunine group had grade 3 or 4 adverse events, including neutropenia, asthenia or fatigue, and constipation, compared with none in the best-supportive care group. These findings indicate that vinflunine improves patient outcomes and is well tolerated; further studies of the role of vinflunine in this setting are therefore warranted.