{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:52:21Z","timestamp":1787014341790,"version":"build-2736575974"},"reference-count":12,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T00:00:00Z","timestamp":1778112000000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"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":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the prevalence of European Association of Urology\u2010defined combination and platinum eligibility at first\u2010line treatment initiation, and to assess their impact on conventional treatment sequence and overall survival in a real\u2010world Japanese cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed 148 patients with metastatic urothelial carcinoma who initiated systemic chemotherapy between 2018 and 2024 at a single institution in Japan. Cisplatin eligibility was assessed according to the Galsky criteria. Combination therapy eligibility and platinum eligibility were defined according to the European Association of Urology guideline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among the 148 patients, 128 (86.5%) were combination\u2010eligible and 20 (13.5%) ineligible. Among combination\u2010eligible patients, 70 (54.7%) were cisplatin\u2010eligible, 47 (36.7%) cisplatin\u2010ineligible but platinum\u2010eligible, and 11 (8.6%) platinum\u2010ineligible. Median overall survival was significantly longer in combination\u2010eligible patients than in combination\u2010ineligible patients (25 vs. 16\u2009months,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.019, HR 2.46, 95% CI 1.16\u20135.23). Within the combination\u2010eligible group, cisplatin\u2010eligible patients tended to show superior median overall survival (not reached) compared with cisplatin\u2010ineligible\/platinum\u2010eligible (25\u2009months) and platinum\u2010ineligible (15\u2009months,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.11 and\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.082, respectively). Only 25.0% (32\/128) of combination\u2010eligible patients received the chemotherapy\u2013immune checkpoint inhibitor\u2013enfortumab vedotin sequence, while 20.0% (4\/20) of combination\u2010ineligible patients also completed this sequence.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>European Association of Urology\u2010defined combination and platinum eligibility were associated with survival outcomes and treatment sequence capability in a real\u2010world setting. These findings highlight the prognostic value but practical limitations of eligibility criteria, emphasizing the need to develop more practical classification frameworks that ensure broader access to effective therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/iju.70403","type":"journal-article","created":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T10:19:00Z","timestamp":1778149140000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of European Association of Urology Combination and Platinum Eligibility on Real\u2010World Treatment Sequences and Survival in Japanese Patients With Metastatic Urothelial Carcinoma"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6494-819X","authenticated-orcid":false,"given":"Takashi","family":"Kawahara","sequence":"first","affiliation":[{"name":"Department of Urology, Faculty of Medicine University of Tsukuba  Tsukuba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiyuki","family":"Nagumo","sequence":"additional","affiliation":[{"name":"Department of Urology, Faculty of Medicine University of Tsukuba  Tsukuba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kozaburo","family":"Tanuma","sequence":"additional","affiliation":[{"name":"Department of Urology, Faculty of Medicine University of Tsukuba  Tsukuba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuki","family":"Hamada","sequence":"additional","affiliation":[{"name":"Department of Urology, Faculty of Medicine University of Tsukuba  Tsukuba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5878-0308","authenticated-orcid":false,"given":"Akane","family":"Yamaguchi","sequence":"additional","affiliation":[{"name":"Department of Urology, Faculty of Medicine University of Tsukuba  Tsukuba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2855-1061","authenticated-orcid":false,"given":"Satoshi","family":"Nitta","sequence":"additional","affiliation":[{"name":"Department of Urology, Faculty of Medicine University of Tsukuba  Tsukuba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8610-0149","authenticated-orcid":false,"given":"Masanobu","family":"Shiga","sequence":"additional","affiliation":[{"name":"Department of Urology, Faculty of Medicine University of Tsukuba  Tsukuba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Ikeda","sequence":"additional","affiliation":[{"name":"Department of Urology, Faculty of Medicine University of Tsukuba  Tsukuba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9989-2285","authenticated-orcid":false,"given":"Akio","family":"Hoshi","sequence":"additional","affiliation":[{"name":"Department of Urology, Faculty of Medicine University of Tsukuba  Tsukuba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4621-8470","authenticated-orcid":false,"given":"Shuya","family":"Kandori","sequence":"additional","affiliation":[{"name":"Department of Urology, Faculty of Medicine University of Tsukuba  Tsukuba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Nishiyama","sequence":"additional","affiliation":[{"name":"Department of Urology, Faculty of Medicine University of Tsukuba  Tsukuba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,7]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2000.18.17.3068"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2035807"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2302098"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470\u20102045(25)00158\u20105"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1613683"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2002788"},{"key":"e_1_2_13_8_1","unstructured":"European Association of Urology \u201cEAU Guidelines on Muscle\u2010Invasive and Metastatic Bladder Cancer \u201d (2024) https:\/\/uroweb.org\/guidelines."},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.34.8433"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/iju.15411"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/iju.70113"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/iju.15473"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.21873\/anticanres.17162"}],"container-title":["International Journal of 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