{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T22:00:29Z","timestamp":1783720829426,"version":"3.55.0"},"reference-count":34,"publisher":"Wiley","issue":"18","license":[{"start":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T00:00:00Z","timestamp":1757635200000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["25K02769"],"award-info":[{"award-number":["25K02769"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Oncological outcomes in patients with urothelial carcinoma treated with avelumab maintenance therapy or conventional platinum\u2010based first\u2010line chemotherapy were compared in real\u2010world practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Outcomes in patients with advanced urothelial carcinoma treated with platinum\u2010based first\u2010line chemotherapy without avelumab (chemo group,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009300) or avelumab maintenance therapy (avelumab group,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200985) between March 2004 and September 2024 were retrospectively evaluated. Overall survival (OS) in the chemo and avelumab groups was stratified by the number of cycles of first\u2010line chemotherapy. The primary outcome was OS among patients without progressive disease (non\u2010PD) at the cycle\u20104 assessment (the standard\u2010switch cohort). The secondary outcome was OS among patients with non\u2010PD at the cycles\u20102 to 3 assessment (the early\u2010switch cohort).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In the standard\u2010switch cohort (non\u2010PD at cycle 4), the chemo and avelumab groups comprised 122 and 47 patients, respectively; median OS was significantly longer with avelumab than with chemo (70 vs. 26\u2009months;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.015). In the early\u2010switch cohort (non\u2010PD at cycles 2\u20133), the chemo and avelumab groups comprised 104 and 35 patients, respectively; median OS was significantly longer with avelumab than with chemo (33 vs. 13\u2009months;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002). A multivariable Cox regression analysis revealed that avelumab administration was significantly associated with a reduced risk of OS (hazard ratio, 0.37;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). The retrospective design is a limitation of this study.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Avelumab maintenance appeared to improve outcomes across cycles 2\u20133 and \u2265\u20094, though residual confounding cannot be excluded.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.71241","type":"journal-article","created":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T11:37:43Z","timestamp":1757677063000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Effects of Avelumab Maintenance on Advanced Urothelial Carcinoma: A Real\u2010World Multicenter Study"],"prefix":"10.1002","volume":"14","author":[{"given":"Noritaka","family":"Ishii","sequence":"first","affiliation":[{"name":"Department of Urology Hirosaki University Graduate School of Medicine  Hirosaki Japan"},{"name":"Department of Urology Aomori Rosai Hospital  Hachinohe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuya","family":"Sekine","sequence":"additional","affiliation":[{"name":"Department of Urology Akita University Graduate School of Medicine  Akita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masanao","family":"Shinohara","sequence":"additional","affiliation":[{"name":"Department of Urology Ageo Central General Hospital  Ageo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yohei","family":"Kawashima","sequence":"additional","affiliation":[{"name":"Department of Urology Ageo Central General Hospital  Ageo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanami","family":"Mori","sequence":"additional","affiliation":[{"name":"Department of Urology Akita University Graduate School of Medicine  Akita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mizuki","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Urology Akita University Graduate School of Medicine  Akita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5899-1738","authenticated-orcid":false,"given":"Kazuyuki","family":"Numakura","sequence":"additional","affiliation":[{"name":"Department of Urology Akita University Graduate School of Medicine  Akita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jotaro","family":"Mikami","sequence":"additional","affiliation":[{"name":"Department of Urology Mutsu General Hospital  Mutsu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoki","family":"Fujita","sequence":"additional","affiliation":[{"name":"Department of Urology Hirosaki University Graduate School of Medicine  Hirosaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teppei","family":"Okamoto","sequence":"additional","affiliation":[{"name":"Department of Urology Hirosaki University Graduate School of Medicine  Hirosaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Yoneyama","sequence":"additional","affiliation":[{"name":"Department of Urology Tsugaru General Hospital  Goshogawara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryuji","family":"Tabata","sequence":"additional","affiliation":[{"name":"Department of Urology Ageo Central General Hospital  Ageo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Urology Ageo Central General Hospital  Ageo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomonori","family":"Habuchi","sequence":"additional","affiliation":[{"name":"Department of Urology Akita University Graduate School of Medicine  Akita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chikara","family":"Ohyama","sequence":"additional","affiliation":[{"name":"Department of Advanced Transplant and Regenerative Medicine Hirosaki University Graduate School of Medicine  Hirosaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0026-4079","authenticated-orcid":false,"given":"Shingo","family":"Hatakeyama","sequence":"additional","affiliation":[{"name":"Department of Urology Hirosaki University Graduate School of Medicine  Hirosaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,12]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2312117"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2309863"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/iju.15450"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/iju.15528"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/iju.14281"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/iju.15362"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/iju.15497"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/iju.15686"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/iju.70040"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/iju.70023"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/iju.70162"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/iju.70136"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/iju.70178"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/iju.70113"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/iju.70086"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2002788"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctrv.2021.102187"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clgc.2024.102212"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2024.1403120"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10147-024-02573-5"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/iju.15278"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/iju.15473"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/iju.15411"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.3390\/curroncol31090420"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euo.2024.09.014"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1093\/jjco\/hyae137"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-72755-8"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11523-024-01099-0"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2024.42.4_suppl.633"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.21873\/anticanres.16922"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.esmorw.2024.100068"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2023.09.2826"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.esmoop.2023.102050"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/iju.14778"}],"container-title":["Cancer Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cam4.71241","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T08:28:56Z","timestamp":1766219336000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/cam4.71241"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9]]},"references-count":34,"journal-issue":{"issue":"18","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1002\/cam4.71241"],"URL":"https:\/\/doi.org\/10.1002\/cam4.71241","archive":["Portico"],"relation":{},"ISSN":["2045-7634","2045-7634"],"issn-type":[{"value":"2045-7634","type":"print"},{"value":"2045-7634","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9]]},"assertion":[{"value":"2025-02-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e71241"}}