Randomized phase III trial results have demonstrated enfortumab vedotin (EV), an antibody–drug conjugate (ADC) consisting of an anti-Nectin-4 human IgG1 monoclonal antibody and monomethyl auristatin E, is a useful treatment for patients with locally advanced or metastatic urothelial carcinoma (la/mUC) that progressed after immune checkpoint inhibitor (ICI) therapies. This multicenter retrospective cohort study aimed to identify predictive factors for the efficacy of EV therapy and prolonged overall survival (OS) of patients in clinical practice. This study included patients with la/mUC who received ICI treatment. Patients who subsequently received EV treatment, those who received non-EV chemotherapy, and those who received no treatment were defined as EV, non-EV, and best supportive care (BSC) groups, respectively. The median OS was 20, 15, and 7 months in the EV, non-EV, and BSC groups, respectively (p < 0.001). Patients with la/mUC who had a complete or partial response after EV treatment had a significantly prolonged OS compared with those with stable or progressive disease. Univariate analysis showed age, neutrophil-to-lymphocyte ratio (NLR), dysgeusia, and rash as independent predictors of OS improvement. NLR and dysgeusia were independent predictors of OS after EV in multivariate analysis. Patients without these factors had a significantly prolonged OS compared to those with both factors. In real-world practice, EV therapy is an effective treatment for patients with la/mUC after ICI treatment.

Background: This study investigated the effect of mannitol administration on postoperative renal function during robot-assisted partial nephrectomy (RAPN) in patients with renal cell carcinoma (RCC). Methods: Patients with RCC who underwent RAPN at eight Japanese facilities between March 2016 and November 2023 were enrolled. In this study, patients were categorized into two groups according to those who received mannitol during RAPN (Group I) and those who did not receive mannitol (Group II). Differences in covariates between the two groups were adjusted using propensity score matching (PSM). Results: The study included 1530 patients with RCC who underwent RAPN. PSM was performed on 531 participants in each group. No difference was observed in perioperative outcomes between the two groups in terms of length of hospital stay, surgical outcomes, achievement ratio of Trifecta, and estimated glomerular filtration rate at 28 days, 90 days, and 1 year postoperatively. Conclusions: Intraoperative mannitol administration during RAPN for improving renal function may be unnecessary.