{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T07:10:49Z","timestamp":1791616249116,"version":"4.3.4"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T00:00:00Z","timestamp":1759708800000},"content-version":"vor","delay-in-days":30,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Enfortumab vedotin combined with pembrolizumab (EV-P) has become the new standard first-line therapy for patients with advanced urothelial carcinoma (aUC), based on its superior efficacy over platinum-based chemotherapy. As this regimen is increasingly adopted in routine care, treatment decisions may often occur in sites without dedicated genitourinary oncology expertise. This global survey aimed to explore how physicians perceive clinical factors that may influence the safe and effective use of EV-P in daily practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and methods<\/jats:title>\n                    <jats:p>A panel of international physicians with experience in treating patients with genitourinary cancers developed a 17-question survey addressing practice settings, experience in managing aUC, and clinical considerations relevant to the use of EV-P. The participants were recruited through a network-based convenience sampling method. The responses were descriptively analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 201 genitourinary physicians from 32 countries completed the questionnaire. The most frequently cited potential absolute contraindications were sensory or motor neuropathy grade\u2009\u22652 (64.2%), ECOG-PS\u2009\u22653 (59.2%), and non\u2013urothelial component &amp;gt;50% of the tissue sample (59.2%). Other notable concerns included severe corneal\/retinal abnormalities, HbA1c &amp;gt;11%, severe skin comorbidities, liver impairment grade \u22652, and dialysis dependence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and relevance<\/jats:title>\n                    <jats:p>This survey provides practical insights into real-world physician perspectives on patient selection for EV-P. The findings highlight the need for guidance to support personalized risk assessment, facilitate early identification of patients who may require enhanced monitoring, and optimize safe integration of EV-P into clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/oncolo\/oyaf333","type":"journal-article","created":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T12:15:14Z","timestamp":1759320914000},"source":"Crossref","is-referenced-by-count":3,"title":["Guiding first-line treatment decisions \tin advanced urothelial carcinoma: a global survey"],"prefix":"10.1093","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0134-4732","authenticated-orcid":false,"given":"Enrique","family":"Grande","sequence":"first","affiliation":[{"name":"Department of Medical Oncology, MD Anderson Cancer Center Madrid and Universidad Francisco de Vitoria\/Facultad de Medicina , Madrid 28033,","place":["Spain"]},{"name":"Facultad de Medicina, Universidad Francisco de Vitoria , Pozuelo de Alarc\u00f3n 28223,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joaquim","family":"Bellmunt","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Dana Farber Cancer Institute , Boston, MA 02215,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syed A","family":"Hussain","sequence":"additional","affiliation":[{"name":"Division of Clinical Medicine, University of Sheffield, School of Medicine and Population Health , Sheffield S10 2RX,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mubarak M","family":"Al Mansour","sequence":"additional","affiliation":[{"name":"Princess Noorah Oncology Center, Oncology Department, King Abdulaziz Medical City Ministry of National Guard Health Affairs , Jeddah 22384,","place":["Kingdom of Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5996-7262","authenticated-orcid":false,"given":"Aristotle","family":"Bamias","sequence":"additional","affiliation":[{"name":"2nd Propaedeutic Department of Internal Medicine, National & Kapodistrian University of Athens , Chaidari 12462,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Barth\u00e9l\u00e9my","sequence":"additional","affiliation":[{"name":"Medical Oncology Department, University Hospital Strasbourg , Strasbourg 67000,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2392-886X","authenticated-orcid":false,"given":"David J","family":"Benjamin","sequence":"additional","affiliation":[{"name":"Medical Oncology, Hoag Family Cancer Institute , Newport Beach, CA 92663,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2698-4362","authenticated-orcid":false,"given":"Normand","family":"Blais","sequence":"additional","affiliation":[{"name":"Medicine, CHUM , Montreal H2X 0C1,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria T","family":"Bourlon","sequence":"additional","affiliation":[{"name":"Hemato-Oncology Department, Urologic Oncology Clinic, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n , Mexico City 14080,","place":["Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Castellano","sequence":"additional","affiliation":[{"name":"Medical Oncology, Hospital Universitario 12 de Octubre , Madrid 28041,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pongwut","family":"Danchaivijitr","sequence":"additional","affiliation":[{"name":"Department of Medicine, Faculty of Medicine, Siriraj Hospital Mahidol University , Bangkok 10700,","place":["Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauricio","family":"Fernandez Lazzaro","sequence":"additional","affiliation":[{"name":"Department of Uro-Oncology, Fundacion COIR , Mendoza, M5500","place":["Argentina"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrizia","family":"Giannatempo","sequence":"additional","affiliation":[{"name":"Department of Genitourinary Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori , Milan 20133,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F\u00e9lix","family":"Guerrero-Ramos","sequence":"additional","affiliation":[{"name":"Department of Urology, Hospital Universitario 12 de Octubre , Madrid 28041,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Iacovelli","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, Medical Oncology Unit, Catholic University of Sacro Cure\u2014Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome 00168,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Ivanyi","sequence":"additional","affiliation":[{"name":"Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School , Hannover 30625,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eun Hee","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Hematology and Medical Oncology, Seoul National University Bundang Hospital , Seongnam-si 13620,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravindran","family":"Kanesvaran","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, National Cancer Centre Singapore , Singapore 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S","family":"Merseburger","sequence":"additional","affiliation":[{"name":"Department of Urology, University Hospital Schleswig-Holstein, University L\u00fcbeck , L\u00fcbeck 23562,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Mukherji","sequence":"additional","affiliation":[{"name":"Department of Hematology Oncology, Clemenceau Medical Center Dubai , Dubai,","place":["United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chandler H","family":"Park","sequence":"additional","affiliation":[{"name":"School of Medicine, Norton Cancer Institute\/University of Louisville , Louisville, KY 40202,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben","family":"Tran","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Peter MacCallum Cancer Centre , Melbourne 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