Enfortumab Vedotin Demonstrates Real-World Efficacy Among Patients With Metastatic Urothelial Carcinoma

According to results from a retrospective study, single-agent enfortumab vedotin, a nectin-4 directed antibody drug conjugate (ADC), demonstrated real-world efficacy among previously treated patients with metastatic urothelial carcinoma. 

Enfortumab vedotin is “indicated for patients with metastatic urothelial carcinoma who have received prior platinum-based chemotherapy and PD-1/L1 inhibitors or are ineligible for cisplatin-containing regimens and have undergone at least one prior line of therapy,” stated Nicolas Sayegh, MD, Huntsman Cancer Institute, Salt Lake City, Utah, and coauthors. “However, real-world effectiveness of [enfortumab vedotin] based on treatment line and impact of prior therapy remains unclear.”

Using data from the nationwide Flatiron Health electronic health record database, researchers identified 371 patients with advanced, recurrent, or metastatic urothelial carcinoma of the upper or lower tract who received single-agent enfortumab vedotin in the second (n = 157), third (n = 132), fourth (n = 62), or fifth (n = 20) lines after previously receiving either platinum-based chemotherapy (22%) or PD-1/L1 inhibitors (48%). Primary end points included median time to next therapy and overall survival (OS), based on treatment line and prior therapy. 

At analysis, median time to next therapy and OS results varied based on treatment line. Patients who previously received platinum-based chemotherapy demonstrated longer time to next therapy and OS, particularly seen among patients treated in the fourth-line setting. 

“EV demonstrates efficacy in patients with mUC regardless of prior receipt of platinum-based chemotherapy and PD-1/L1 inhibitors or treatment line,” concluded Dr Sayegh et al. “While only hypothesis-generating, these findings provide valuable insights for patient counseling, prognostication, and therapeutic decision-making in clinical practice.”

Source: 

Sayegh N, Jo Y, Gebrael G, et al. Real-world effectiveness of single-agent enfortumab vedotin in patients with advanced urothelial carcinoma. Clin Genitourin Cancer. Published online: December 6, 2024. doi:  10.1016/j.clgc.2024.102287