{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T13:25:48Z","timestamp":1787664348956,"version":"build-2736575974"},"reference-count":18,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"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>Enfortumab vedotin (EV) has shown survival benefits in advanced urothelial carcinoma (UC). However, patients with severe renal impairment, poor performance status, or anemia were excluded from pivotal trials. Evidence regarding real\u2010world outcomes of EV in trial\u2010ineligible populations remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We retrospectively investigated 180 patients with advanced UC treated with EV between December 2021 and December 2024 at Kobe University Hospital or affiliated institutions. Patients were classified as trial\u2010eligible or trial\u2010ineligible using modified EV\u2010301 eligibility criteria based on three factors: estimated glomerular filtration rate &lt;\u200930\u2009mL\/min\/1.73\u2009m\n                      <jats:sup>2<\/jats:sup>\n                      , Eastern Cooperative Oncology Group performance status \u2265\u20092, and hemoglobin &lt;\u20099\u2009g\/dL. Progression\u2010free survival (PFS), overall survival (OS), objective response rate (ORR), and adverse events were evaluated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The median age was 73\u2009years, and 73.3% of the patients were male. Eighty\u2010two patients (45.6%) were trial\u2010ineligible. Median PFS (8.0 vs. 5.0\u2009months,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005) and OS (17.9 vs. 10.5\u2009months,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001) were significantly longer in trial\u2010eligible patients. ORR was also higher in the trial\u2010eligible group (55.1% vs. 31.7%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003). The incidence of all\u2010grade and grade \u2265\u20093 adverse events was comparable. Subgroup analyses demonstrated significantly poorer PFS and OS in patients with Eastern Cooperative Oncology Group performance status \u2265\u20092 or hemoglobin &lt;\u20099\u2009g\/dL. Outcomes did not differ according to renal function.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Clinical outcomes following EV were poorer in trial\u2010ineligible patients than in trial\u2010eligible patients, while safety was comparable between the groups. Poor performance status and anemia were associated with worse survival outcomes, whereas severe renal impairment was not significantly associated with survival outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/iju.70614","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T08:32:57Z","timestamp":1787214777000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and Safety of Enfortumab Vedotin by Trial Eligibility in Advanced Urothelial Carcinoma: A Multicenter Real\u2010World Study"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-1353-7789","authenticated-orcid":false,"given":"Naoto","family":"Wakita","sequence":"first","affiliation":[{"name":"Department of Urology Kobe University Graduate School of Medicine  Kobe 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