{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T02:40:36Z","timestamp":1792636836710,"version":"4.5.0"},"reference-count":13,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T00:00:00Z","timestamp":1780358400000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"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":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to evaluate the clinical relevance of early relative dose intensity (eRDI) during enfortumab vedotin (EV) monotherapy in patients with metastatic urothelial carcinoma (mUC) based on a Japanese real\u2010world multicenter cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed 119 patients with mUC who received EV. The temporal trend of total relative dose intensity (tRDI), defined as the cumulative relative dose intensity during treatment, was assessed over the first 5\u2009months. eRDI, calculated as the mean RDI over the initial 3\u2009months, was also evaluated. Survival analyses were performed in 84 patients evaluable beyond the first radiographic assessment, excluding those with early progressive disease (PD). Patients were stratified by eRDI (\u2265\u200980% vs. &lt;\u200980%), and progression\u2010free survival (PFS) and overall survival (OS) were compared. Subgroup analyses were conducted according to the presence or absence of adverse event\u2013related dose modification (AE\u2010related DM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Dose intensity gradually declined during the early treatment phase. The eRDI was not significantly associated with PFS or OS in the PD\u2010excluded cohort (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200984). However, among patients without AE\u2010related DM (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200944), high eRDI was associated with significantly longer PFS (median 11.7 vs. 4.2\u2009months;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001) and OS (not reached vs. 13.8\u2009months;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.021). No significant association was observed between eRDI and survival in patients with AE\u2010related DM.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although eRDI was not an overall significant prognostic factor, it showed clinical relevance in patients without AE\u2010related DM. These findings underscore the importance of preserving eRDI in patients with sufficient tolerability and support individualized dosing strategies for EV therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/iju.70523","type":"journal-article","created":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T05:03:13Z","timestamp":1780462993000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Impact of Early Relative Dose Intensity on Survival in Patients Receiving Enfortumab Vedotin for Metastatic Urothelial Carcinoma: A Japanese Real\u2010World Multicenter Study"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-0787-9321","authenticated-orcid":false,"given":"Yuki","family":"Endo","sequence":"first","affiliation":[{"name":"Department of Urology Nippon Medical School Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7108-7811","authenticated-orcid":false,"given":"Yuma","family":"Sakura","sequence":"additional","affiliation":[{"name":"Division of Urology Shizuoka Cancer Center  Shizuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Go","family":"Kaneko","sequence":"additional","affiliation":[{"name":"Department of Uro\u2010Oncology Saitama Medical University International Medical Center  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1511-9664","authenticated-orcid":false,"given":"Nozomi","family":"Hayakawa","sequence":"additional","affiliation":[{"name":"Department of Urology St. Marianna University School of Medicine  Kawasaki Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daiki","family":"Ikarashi","sequence":"additional","affiliation":[{"name":"Department of Urology Iwate Medical University School of Medicine  Iwate Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4131-1185","authenticated-orcid":false,"given":"Ryo","family":"Yamashita","sequence":"additional","affiliation":[{"name":"Division of Urology Shizuoka Cancer Center  Shizuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3581-2039","authenticated-orcid":false,"given":"Suguru","family":"Shirotake","sequence":"additional","affiliation":[{"name":"Department of Uro\u2010Oncology Saitama Medical University International Medical Center  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2720-9640","authenticated-orcid":false,"given":"Wataru","family":"Obara","sequence":"additional","affiliation":[{"name":"Department of Urology Iwate Medical University School of Medicine  Iwate Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukihiro","family":"Kondo","sequence":"additional","affiliation":[{"name":"Department of Urology Nippon Medical School Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1624-6676","authenticated-orcid":false,"given":"Eiji","family":"Kikuchi","sequence":"additional","affiliation":[{"name":"Department of Urology St. Marianna University School of Medicine  Kawasaki Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,2]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2035807"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2312117"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/iju.15411"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.19.01140"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/jjco\/hyae082"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/curroncol31020056"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(05)70255-2"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.4103\/UROS.UROS_145_20"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clgc.2025.102326"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.21873\/invivo.13843"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/jjco\/hyad170"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.34057"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10147-025-02822-1"}],"container-title":["International 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