{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T20:45:56Z","timestamp":1791924356437,"version":"4.3.4"},"reference-count":22,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"10","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Precis Oncol"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>Enfortumab vedotin and pembrolizumab (EVP) is the standard first-line treatment for locally advanced and metastatic urothelial cancer (la\/mUC) although response biomarkers remain an unmet need. Tumor-informed circulating tumor DNA (ctDNA) has proven to be useful as a marker of response in a variety of cancers. We sought to explore whether ctDNA dynamics is associated with survival outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>This retrospective study included patients with la\/mUC receiving first-line EVP, who had plasma ctDNA collected using the Signatera assay within 3 months after treatment initiation. Associations between ctDNA clearance and overall survival (OS) and progression-free survival (PFS) were assessed using multivariable time-dependent Cox proportional hazard (CPH) models and landmark analyses at 1, 2, and 3 months after EVP initiation. Longitudinal ctDNA trends were examined in a subpopulation with baseline ctDNA values collected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Fifty-eight patients were included. In multivariable time-dependent CPH models, ctDNA clearance was associated with both OS (hazard ratio [HR], 0.04 [95% CI, 0.01 to 0.24],\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001) and PFS (HR, 0.09 [95% CI, 0.02 to 0.32],\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001). In landmark analyses, ctDNA clearance was associated with longer OS and PFS at 2 months (log-rank test\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .003,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001, respectively). Among patients with baseline ctDNA (n = 42), 69% achieved ctDNA clearance after EVP initiation, whereas just 14% (n = 6) never had a decrease in ctDNA. The median time to clearance of ctDNA was 1.41 months (IQR, 0.85-1.94).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>While primarily hypothesis-generating, this study suggests that patients with la\/mUC treated with first-line EVP frequently and rapidly clear ctDNA. Clearance of ctDNA in this population is associated with longer survival and merits further study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/po-26-00691","type":"journal-article","created":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T19:59:07Z","timestamp":1791921547000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":0,"title":["Real-World Tumor-Informed Circulating Tumor DNA Dynamics and Survival Associations in Advanced Urothelial Cancer Treated With First-Line Enfortumab Vedotin and Pembrolizumab"],"prefix":"10.1200","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-9833-0867","authenticated-orcid":true,"given":"Vivek","family":"Nimgaonkar","sequence":"first","affiliation":[{"name":"Johns Hopkins University Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alyssa","family":"Arbuiso","sequence":"additional","affiliation":[{"name":"Johns Hopkins School of Medicine, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evangelia","family":"Vlachou","sequence":"additional","affiliation":[{"name":"Osler Internal Medicine Program, Johns Hopkins Hospital, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7180-8790","authenticated-orcid":true,"given":"Burles Avner","family":"Johnson","sequence":"additional","affiliation":[{"name":"Johns Hopkins University Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD"},{"name":"Johns Hopkins Greenberg Bladder Cancer Institute, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3846-0235","authenticated-orcid":true,"given":"Armine","family":"Smith","sequence":"additional","affiliation":[{"name":"Sibley Memorial Health, Johns Hopkins Medicine, Washington, DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Max","family":"Kates","sequence":"additional","affiliation":[{"name":"James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunil","family":"Patel","sequence":"additional","affiliation":[{"name":"James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9495-6983","authenticated-orcid":true,"given":"Nirmish","family":"Singla","sequence":"additional","affiliation":[{"name":"Johns Hopkins University Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD"},{"name":"James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Russell","sequence":"additional","affiliation":[{"name":"Johns Hopkins University Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelli","family":"Rourke","sequence":"additional","affiliation":[{"name":"Johns Hopkins University Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8555-4322","authenticated-orcid":true,"given":"Roy","family":"Elias","sequence":"additional","affiliation":[{"name":"Johns Hopkins University Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0990-1115","authenticated-orcid":true,"given":"Andres","family":"Matoso","sequence":"additional","affiliation":[{"name":"Johns Hopkins School of Medicine, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6932-8985","authenticated-orcid":true,"given":"Ezra G.","family":"Baraban","sequence":"additional","affiliation":[{"name":"Johns Hopkins School of Medicine, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1016-9024","authenticated-orcid":false,"given":"Noah M.","family":"Hahn","sequence":"additional","affiliation":[{"name":"Johns Hopkins University Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD"},{"name":"Johns Hopkins Greenberg Bladder Cancer Institute, Baltimore, MD"},{"name":"James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, 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