Enfortumab Vedotin in Previously Treated Advanced Urothelial Carcinoma

Current Systemic Treatment Options in Metastatic Urothelial Carcinoma after Progression on Checkpoint Inhibition Therapy—A Systemic Review Combined with Single-Group Meta-Analysis of Three Studies Testing Enfortumab Vedotin

“…With the advent of CPIs, the question arose as to whether these chemotherapy regimens could be useful further down the sequence, after progression on CPI therapy. The phase 3 EV-301 study [42] compared the antibody-drug conjugate (ADC) Enfortumab vedotin (EV) (see separate data below) with CT with docetaxel, paclitaxel, or Vinflunine for mUC after prior platinum-based CT and CPI therapy. The patients were randomized in a 1:1 ratio.…”

“…The data from the subsequent phase 3 clinical study EV-301 has just been published [42]. It compared the use of EV with CT with docetaxel, paclitaxel, or Vinflunine for patients with mUC after prior platinum-based CT and CPI therapy.…”

“…The response data of 487 patients (n = 74 [40] + 125 [41] + 288 [42]) were analyzed via single-group meta-analysis. The ORR was 42.1% (95% CI, 37.8-46.5), with 8.5% (95% CI, 4.6-15.1) CR and 34.5% (95% CI, 30.4-38.9) PR.…”

Cutaneous reactions with enfortumab vedotin: A case series and review of the literature

“…Enfortumab vedotin (EV) is a novel treatment for patients with advanced urothelial carcinoma who have failed platinum-based chemotherapy and immunotherapy. 1 EV is an antibody-drug conjugate (ADC) composed of a humanized anti-nectin-4 monoclonal antibody attached to a microtubule inhibitor. 2 We report 3 individuals with unique cutaneous reactions after EV treatment.…”

Re: Thomas Powles, Jonathan E. Rosenberg, Guru P. Sonpavde, et al. Enfortumab Vedotin in Previously Treated Advanced Urothelial Carcinoma. N Engl J Med 2021;384:1125–35

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Powles and colleagues [1] reported results from the EV-301 trial, which assessed the advantage in overall survival and progression-free survival of enfortumab vedotin over taxane or vinflunine monotherapy among patients with advanced urothelial carcinoma who had prior treatment with platinum-based chemotherapy and immunotherapy. Less than half of the patients receiving the antibody-drug conjugate responded to treatment (40.6%), with these findings suggesting a possible role of currently unknown resistance mechanisms.

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