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Urological cancer

Harnessing potent therapies with care: enfortumab vedotin plus pembrolizumab for advanced-stage urothelial carcinoma

Following the recent FDA Accelerated Approval of enfortumab vedotin (EV) plus pembrolizumab for patients with advanced-stage urothelial carcinoma who are cisplatin-ineligible, herein we highlight key clinical outcomes with this combination based on results from Cohort K of the pivotal phase Ib/II EV-103 trial. We also discuss treatment sequencing, de-escalation strategies and toxicity management as EV–pembrolizumab becomes widely used in clinical practice.

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References

  1. Galsky, M. D. et al. Treatment of patients with metastatic urothelial cancer “unfit” for cisplatin-based chemotherapy. J. Clin. Oncol. 29, 2432–2438 (2011).

    Article  PubMed  Google Scholar 

  2. Dogliotti, L. et al. Gemcitabine plus cisplatin versus gemcitabine plus carboplatin as first-line chemotherapy in advanced transitional cell carcinoma of the urothelium: results of a randomized phase 2 trial. Eur. Urol. 52, 134–141 (2007).

    Article  CAS  PubMed  Google Scholar 

  3. De Santis, M. et al. Randomized phase II/III trial assessing gemcitabine/carboplatin and methotrexate/carboplatin/vinblastine in patients with advanced urothelial cancer who are unfit for cisplatin-based chemotherapy: EORTC study 30986. J. Clin. Oncol. 30, 191–199 (2012).

    Article  PubMed  Google Scholar 

  4. Sridhar, S. S. et al. Avelumab first-line (1L) maintenance for advanced urothelial carcinoma (UC): long-term follow-up from the JAVELIN Bladder 100 trial in subgroups defined by 1L chemotherapy regimen and analysis of overall survival (OS) from start of 1L chemotherapy. J. Clin. Oncol. 41 (Suppl. 6), abstr 508 (2023).

    Article  Google Scholar 

  5. Hoffman-Censits, J. H. et al. Expression of nectin-4 in bladder urothelial carcinoma, in morphologic variants, and nonurothelial histotypes. Appl. Immunohistochem. Mol. Morphol. 29, 619–625 (2021).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Rosenberg, J. et al. EV-101: a phase I study of single-agent enfortumab vedotin in patients with nectin-4-positive solid tumors, including metastatic urothelial carcinoma. J. Clin. Oncol. 38, 1041–1049 (2020).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. US Food & Drug Administration. FDA grants regular approval to enfortumab vedotin-ejfv for locally advanced or metastatic urothelial cancer. fda.gov, https://www.fda.gov/drugs/resources-information-approved-drugs/fda-grants-regular-approval-enfortumab-vedotin-ejfv-locally-advanced-or-metastatic-urothelial-cancer (2021)

  8. US Food & Drug Administration. FDA grants accelerated approval to enfortumab vedotin-ejfv with pembrolizumab for locally advanced or metastatic urothelial carcinoma. fda.gov, https://www.fda.gov/drugs/resources-information-approved-drugs/fda-grants-accelerated-approval-enfortumab-vedotin-ejfv-pembrolizumab-locally-advanced-or-metastatic (2023)

  9. O’Donnell, P. H. et al. Enfortumab vedotin with or without pembrolizumab in cisplatin-ineligible patients with previously untreated locally advanced or metastatic urothelial cancer. J Clin Oncol. https://doi.org/10.1200/JCO.22.02887 (2023).

    Article  PubMed  Google Scholar 

  10. Hoimes, C. J. et al. Enfortumab vedotin plus pembrolizumab in previously untreated advanced urothelial cancer. J. Clin. Oncol. 41, 22–31 (2023).

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Elizabeth R. Plimack.

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E.R.P. has received financial compensation for scientific advisory roles for Merck and Seagen. The authors declare that they referred patients for enrolment in the EV-103/KEYNOTE-869 trial, which was open at their institution.

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Ghatalia, P., Plimack, E.R. Harnessing potent therapies with care: enfortumab vedotin plus pembrolizumab for advanced-stage urothelial carcinoma. Nat Rev Clin Oncol 20, 818–819 (2023). https://doi.org/10.1038/s41571-023-00814-6

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