{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T11:04:26Z","timestamp":1788433466246,"version":"build-2803163510"},"reference-count":39,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,2,20]],"date-time":"2025-02-20T00:00:00Z","timestamp":1740009600000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Recently, a plethora of novel systemic agents have been incorporated into the therapeutic armamentarium of advanced urothelial carcinoma (aUC). The antibody\u2013drug conjugate (ADC), enfortumab vedotin (EV), has demonstrated relevant clinical benefit in patients with aUC refractory to platinum and immune\u2010checkpoint inhibitor (ICI) therapy. Our study provides a retrospective, international, real\u2010world analysis comparing the effectiveness of EV to chemotherapy in this setting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The data were extracted from the medical records of patients treated with EV or chemotherapy following pembrolizumab for recurrent or progressive aUC after platinum\u2010based chemotherapy. Patients were assessed for overall survival (OS), progression\u2010free survival (PFS), overall response rate (ORR) and duration of response (DoR).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Our analysis included 247 patients treated with EV (88, 36%) or chemotherapy (159, 64%). Median OS was 9.1\u2009months (95%CI 7.2\u201310.7) in the overall study population, 13.6\u2009months (95%CI 10.0\u201331.0) in patients receiving EV and 6.8\u2009months (95%CI 6.0\u20138.9) in patients receiving chemotherapy (<jats:italic>p<\/jats:italic> &lt; 0.001). The OS benefit of EV was not affected by primary tumour site and histology, metastatic sites, type of first platinum\u2010based chemotherapy or response to pembrolizumab. In the EV cohort, the median PFS was significantly longer (8.8\u2009months [95%CI 6.5\u201317.0] vs. 3.0\u2009months [95%CI 2.6\u20133.7]) and the ORR was significantly higher (56% vs. 23%) than in the chemotherapy cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The results of our international analysis of real\u2010world data confirm the effectiveness of EV in the sequential strategy of aUC patients who have received prior platinum\u2010based chemotherapy and anti\u2010PD\u20101 pembrolizumab, regardless of commonly considered prognostic factors.<\/jats:p><jats:p><jats:bold>Trial Registration:<\/jats:bold> <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link> identifier: NCT05290038<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.70479","type":"journal-article","created":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T05:36:22Z","timestamp":1740116182000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Real\u2010Life Impact of Enfortumab Vedotin or Chemotherapy in the Sequential Treatment of Advanced Urothelial Carcinoma: The <scp>ARON<\/scp>\u20102 Retrospective Experience"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7743-741X","authenticated-orcid":false,"given":"Mimma","family":"Rizzo","sequence":"first","affiliation":[{"name":"Medical Oncology Unit Azienda Ospedaliera Universitaria Consorziale Policlinico di Bari  Bari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franco","family":"Morelli","sequence":"additional","affiliation":[{"name":"Medical Oncology Unit IRCCS Casa Sollievo della Sofferenza  Foggia 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T.","family":"Bourlon","sequence":"additional","affiliation":[{"name":"Department of Hemato\u2010Oncology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran Universidad Panamericana  Mexico City Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrique","family":"Grande","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology MD Anderson Cancer Center Madrid  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Massari","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences (DIMEC) University of Bologna  Bologna Italy"},{"name":"Medical Oncology IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Landmesser","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Urologie Universit\u00e4tsklinikum Schleswig\u2010Holstein Campus 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