{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T16:42:39Z","timestamp":1781800959956,"version":"3.54.5"},"reference-count":10,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,7,16]],"date-time":"2025-07-16T00:00:00Z","timestamp":1752624000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["IJU Case Reports"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Enfortumab vedotin plus pembrolizumab (EV\u2009+\u2009<jats:italic>P<\/jats:italic>) shows high efficacy in metastatic urothelial carcinoma (mUC), potentially increasing tumor lysis syndrome (TLS) risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case Presentation<\/jats:title><jats:p>A 64\u2010year\u2010old man with mUC underwent surgery and adjuvant nivolumab after neoadjuvant chemotherapy. Five months post\u2010surgery, EV\u2009+\u2009<jats:italic>P<\/jats:italic> was initiated for recurrence with distant metastasis. Non\u2010contrast computed tomography on Day 15 of therapy revealed marked regression of hepatic and pulmonary metastases and significant reduction of the iliac soft tissue mass, with no evidence of infection. The following day, however, laboratory findings were consistent with TLS, followed by hypotension and respiratory failure. He was transferred to the intensive care unit for multidisciplinary supportive management. After stabilization, he was discharged home, and the second cycle of EV\u2009+\u2009<jats:italic>P<\/jats:italic> was completed uneventfully under prophylactic hydration and uric acid\u2013lowering therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Early recognition and timely multidisciplinary management are essential for favorable outcomes in TLS following EV\u2009+\u2009<jats:italic>P<\/jats:italic> therapy in mUC patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/iju5.70069","type":"journal-article","created":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T04:39:54Z","timestamp":1752727194000},"page":"470-474","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Successful Management of Tumor Lysis Syndrome Following Enfortumab Vedotin Plus Pembrolizumab Therapy in Metastatic Urothelial Carcinoma: A Case Report"],"prefix":"10.1002","volume":"8","author":[{"given":"Daigo","family":"Takemori","sequence":"first","affiliation":[{"name":"Department of Urology Kochi Medical School, Kochi University  Nankoku Kochi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3350-9123","authenticated-orcid":false,"given":"Ryu","family":"Shigehisa","sequence":"additional","affiliation":[{"name":"Department of Urology Kochi Medical School, Kochi University  Nankoku Kochi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sho","family":"Shimasaki","sequence":"additional","affiliation":[{"name":"Department of Urology Kochi Medical School, Kochi University  Nankoku Kochi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika","family":"Yamashita","sequence":"additional","affiliation":[{"name":"Department of Urology Kochi Medical School, Kochi University  Nankoku Kochi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshitaka","family":"Kurano","sequence":"additional","affiliation":[{"name":"Department of Urology Kochi Medical School, Kochi University  Nankoku Kochi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaya","family":"Atagi","sequence":"additional","affiliation":[{"name":"Department of Urology Kochi Medical School, Kochi University  Nankoku Kochi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuhi","family":"Ota","sequence":"additional","affiliation":[{"name":"Department of Urology Kochi Medical School, Kochi University  Nankoku Kochi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinkuro","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Urology Kochi Medical School, Kochi University  Nankoku Kochi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroto","family":"Osakabe","sequence":"additional","affiliation":[{"name":"Department of Urology Kochi Medical School, Kochi University  Nankoku Kochi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoya","family":"Nao","sequence":"additional","affiliation":[{"name":"Department of Urology Kochi Medical School, Kochi University  Nankoku Kochi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsutomu","family":"Shimamoto","sequence":"additional","affiliation":[{"name":"Department of Urology Kochi Medical School, Kochi University  Nankoku Kochi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideo","family":"Fukuhara","sequence":"additional","affiliation":[{"name":"Department of Urology Kochi Medical School, Kochi University  Nankoku Kochi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobutaka","family":"Shimizu","sequence":"additional","affiliation":[{"name":"Pelvic Floor Center Kochi Medical School, Kochi University  Nankoku Kochi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Fukata","sequence":"additional","affiliation":[{"name":"Department of Urology Kochi Medical School, Kochi University  Nankoku Kochi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shingo","family":"Ashida","sequence":"additional","affiliation":[{"name":"Department of Urology Kochi Medical School, Kochi University  Nankoku Kochi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keiji","family":"Inoue","sequence":"additional","affiliation":[{"name":"Department of Urology Kochi Medical School, Kochi University  Nankoku Kochi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,16]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urolonc.2023.03.012"},{"key":"e_1_2_10_3_1","volume-title":"TNM Classification of Malignant Tumours","author":"Brierley J. 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