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Enfortumab Vedotin Appears Well-Tolerated and Active in Advanced Bladder Cancers

Daniel P. Petrylak, MD
Published Online:7:39 PM, Wed August 21, 2019

Daniel P. Petrylak, MD, professor of medicine and urology at Yale Cancer Center, discusses the data from the phase II EV-201 trial investigating enfortumab vedotin as treatment of patients with locally advanced or metastatic urothelial cancer previously treated with platinum-based chemotherapy or a PD-1/PD-L1 checkpoint inhibitor.

Enfortumab vedotin has a unique mechanism of action, says Petrylak. It is an antibody–drug conjugate that targets Nectin-4, which is expressed in lower levels in normal tissue cells in bladder cancers. This agent is able to deliver chemotherapy directly to the cancer cells in this patient population. Petrylak says this targeted therapy could be considered a “smart bomb” based on this activity.

The drug is also well tolerated. In the case of patients developing neuropathy on treatment, holding or reducing enfortumab vedotin caused the neuropathy to go away.  In addition, if the patient had a pre-existing neuropathy, holding or reducing the drug also caused the toxicity to reduce. Petrylak notes similar effects in regard to diabetes or rash in this patient population.

Overall, Petrylak concludes that enfortumab vedotin is a safe and well-tolerated drug in patients with locally advanced or metastatic urothelial cancer. The drug has demonstrated significant activity in this patient population.
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