{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T16:49:54Z","timestamp":1787849394489,"version":"build-2784847793"},"reference-count":19,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"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":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Avelumab maintenance therapy following platinum\u2010based chemotherapy is recommended as an alternative treatment in patients with locally advanced or metastatic urothelial carcinoma; however, real\u2010world data are limited, and no predictive system has been established to identify suitable candidates for avelumab at the initiation of chemotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study analyzed 324 patients with locally advanced or metastatic urothelial carcinoma who received platinum\u2010based chemotherapy. Patients were divided into three groups: 130 who received avelumab (avelumab group), 58 who did not experience disease progression on chemotherapy within 4\u2009cycles but did not receive avelumab (PBC\u2010only group), and 136 who experienced disease progression on chemotherapy within 4\u2009cycles (PBC\u2010PD group). Oncological outcomes were compared among the groups, and a system for predicting the maintained response to chemotherapy for 4 or more cycles was explored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The avelumab group had significantly longer overall survival than the other two groups. After propensity score matching, overall survival was significantly longer in the avelumab group than in the PBC\u2010only group. Lymph node\u2010only metastasis and a low neutrophil\u2010to\u2010lymphocyte ratio were identified as predictive factors for maintaining response to chemotherapy. Among patients with these two factors (favorable group), 81.1% maintained a response, and those who received avelumab maintenance therapy showed that the median overall survival was 33.4\u2009months from initiation of chemotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The survival benefit of avelumab following chemotherapy compared to chemotherapy alone was confirmed. In the favorable group, avelumab following chemotherapy may be a valuable option if they are ineligible or unwilling to receive the preferred regimen.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/iju.70584","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T08:01:46Z","timestamp":1785484906000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Oncological Outcomes and Prognostic Factors of Platinum\u2010Based Chemotherapy Followed by Avelumab Maintenance Therapy Compared With Platinum\u2010Based Chemotherapy Alone: A Propensity Score\u2013Matched Analysis in a Real\u2010World Population"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8159-9793","authenticated-orcid":false,"given":"Yuto","family":"Matsushita","sequence":"first","affiliation":[{"name":"Department of Urology Hamamatsu University School of Medicine  Shizuoka 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