For patients with modest hyperbilirubinemia (Tbili 2-3) due to chronic liver disease, but otherwise normal liver indices, would you consider still utilizing enfortumab vedotin for metastatic urothelial carcinoma?

EV Drug label suggests avoidance in patients with bilirubin >1.5xULN with normal AST.

For a patient such as this, could you empirically dose reduce at the outset? Would you make any other adjustments to use/monitoring?