{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:58:35Z","timestamp":1781571515283,"version":"3.54.5"},"reference-count":30,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T00:00:00Z","timestamp":1751414400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T00:00:00Z","timestamp":1751414400000},"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":["Int J of Urology"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The association between the response to first\u2010line chemotherapy and maintenance of avelumab remains unclear. We identified factors associated with the response to avelumab in patients with advanced urothelial carcinoma using real\u2010world data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively enrolled 100 patients with advanced urothelial carcinoma treated with maintenance avelumab therapy between March 2021 and April 2024 at Nagoya University and nine affiliated hospitals. The complete\/partial\u2010response group was defined as patients with complete response or partial response as the best response to first\u2010line chemotherapy. The stable disease group was defined as patients with stable disease as the best response to first\u2010line chemotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Seven patients (7.0%) achieved complete response, 65 (65.0%) achieved partial response, and 28 (28.0%) achieved stable disease as the best response to first\u2010line chemotherapy. Regarding avelumab therapy, the complete\/partial\u2010response group had significantly better progression\u2010free survival than the stable disease group (median: 11.1 vs. 3.2\u2009months,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). In multivariate analyses, the best response to first\u2010line chemotherapy was the only independent risk factor for progression\u2010free survival (hazard ratio\u2009=\u20091.844, 95% confidence interval\u2009=\u20091.002\u20133.394;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.049). Overall survival was significantly shorter in the stable disease group than in the complete\/partial\u2010response group (median: 14.1\u2009months vs. not reached,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Multivariate analyses revealed significant associations between poor overall survival and performance status (hazard ratio\u2009=\u20092.175, 95% confidence interval\u2009=\u20091.030\u20134.592;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.042) and the best response to first\u2010line chemotherapy (hazard ratio\u2009=\u20094.174, 95% confidence interval\u2009=\u20091.975\u20138.824;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The best response to first\u2010line chemotherapy may predict the clinical outcome of patients with advanced urothelial carcinoma treated with avelumab.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/iju.70162","type":"journal-article","created":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T06:40:52Z","timestamp":1751438452000},"page":"1449-1459","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Response to First\u2010Line Chemotherapy Predicts Response to Maintenance Avelumab Therapy in Japanese Patients With Advanced Urothelial Carcinoma"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0393-5771","authenticated-orcid":false,"given":"Satoshi","family":"Inoue","sequence":"first","affiliation":[{"name":"Department of Urology Nagoya University Graduate School of Medicine  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Hayakawa","sequence":"additional","affiliation":[{"name":"Department of Urology Yokkaichi Municipal Hospital  Yokkaichi 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