{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T01:55:16Z","timestamp":1774576516220,"version":"3.50.1"},"reference-count":9,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,2,15]],"date-time":"2026-02-15T00:00:00Z","timestamp":1771113600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,2,15]],"date-time":"2026-02-15T00:00:00Z","timestamp":1771113600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["IJU Case Reports"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Avelumab is recommended as maintenance therapy for advanced urothelial carcinoma after platinum chemotherapy; however, immune\u2010related adverse events can be severe and refractory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation<\/jats:title>\n                    <jats:p>A 79\u2010year\u2010old male developed immune\u2010related hepatitis during avelumab maintenance therapy following gemcitabine plus carboplatin for metastatic recurrent urothelial carcinoma. Despite discontinuation of avelumab and treatment with high\u2010dose corticosteroids, mycophenolate mofetil, and plasma exchange, liver failure progressed, leading to death on day 106.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Hepatic irAEs during avelumab therapy are rare but potentially fatal. Early recognition and aggressive multidisciplinary management are essential to improve outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/iju5.70150","type":"journal-article","created":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T07:27:45Z","timestamp":1771226865000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Early Recognition of Immune\u2010Related Hepatitis During Avelumab Maintenance Therapy for Urothelial Carcinoma"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-6005-9210","authenticated-orcid":false,"given":"Yuka","family":"Iwama","sequence":"first","affiliation":[{"name":"Department of Urology Nagoya University  Nagoya Aichi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoyasu","family":"Sano","sequence":"additional","affiliation":[{"name":"Department of Urology Nagoya University  Nagoya Aichi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuta","family":"Sano","sequence":"additional","affiliation":[{"name":"Department of Urology Nagoya University  Nagoya Aichi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomokazu","family":"Kimura","sequence":"additional","affiliation":[{"name":"Department of Urology Nagoya University  Nagoya Aichi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yushi","family":"Naito","sequence":"additional","affiliation":[{"name":"Department of Urology Nagoya University  Nagoya Aichi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoshi","family":"Inoue","sequence":"additional","affiliation":[{"name":"Department of Urology Nagoya University  Nagoya Aichi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8574-2932","authenticated-orcid":false,"given":"Kazuna","family":"Matsuo","sequence":"additional","affiliation":[{"name":"Department of Urology Nagoya University  Nagoya Aichi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9338-4781","authenticated-orcid":false,"given":"Shohei","family":"Ishida","sequence":"additional","affiliation":[{"name":"Department of Urology Nagoya University  Nagoya Aichi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7823-2600","authenticated-orcid":false,"given":"Yoshihisa","family":"Matsukawa","sequence":"additional","affiliation":[{"name":"Department of Urology Nagoya University  Nagoya Aichi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shusuke","family":"Akamatsu","sequence":"additional","affiliation":[{"name":"Department of Urology Nagoya University  Nagoya Aichi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,2,15]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.22.01792"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.2217\/fon-2020-1222"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2020.00005"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.21.01440"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12113751"},{"key":"e_1_2_10_7_1","unstructured":"National Comprehensive Cancer Network \u201cNCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines): Management of Immunotherapy\u2010Related Toxicities \u201dVersion 1.2025."},{"issue":"14","key":"e_1_2_10_8_1","article-title":"Managing Potential Adverse Events During Treatment With Enfortumab Vedotin + Pembrolizumab in Patients With Advanced Urothelial Cancer","volume":"22","author":"Blaine B.","year":"2024","journal-title":"Frontiers in Oncology"},{"issue":"7","key":"e_1_2_10_9_1","first-page":"1008","article-title":"Treatment\u2010Related Adverse Events of PD\u20101 and PD\u2010L1 Inhibitors in Clinical Trials: A Systematic Review and Meta\u2010Analysis","volume":"15","author":"Yucai W.","year":"2019","journal-title":"JAMA Oncology"},{"issue":"14","key":"e_1_2_10_10_1","first-page":"729","article-title":"Clinical Evaluation of Avelumab in the Treatment of Advanced Urothelial Carcinoma: Focus on Patient Selection and Outcomes","volume":"22","author":"Jennifer E.","year":"2022","journal-title":"Cancer Management and Research"}],"container-title":["IJU Case 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