Enfortumab vedotin (EV) is the first antibody drug conjugate therapy approved for advanced urothelial cancer (aUC). EV monotherapy is approved in the US and Europe as later-line therapy (post- immune checkpoint inhibitor therapy and platinum-based chemotherapy), and in the US alone as earlier-line therapy (cisplatin-ineligible, ≥1 prior therapy), based on results from a randomized study (EV 301) and a single arm study (EV 201) [1,2]. Because EV monotherapy delivery per current labelling (1.25 mg/kg, day 1, 8, 15 of a 28-day cycle) may differ from delivery in routine practice [3], we examined real-world EV use, dose intensity and adherence across 280 US cancer clinics.