Enfortumab vedotin (EV) is the first antibody-drug conjugate approved for locally advanced or metastatic urothelial cancers (la/mUCs), a disease group historically associated with limited prognosis and therapeutic options. EV consists of monomethyl auristatin E, a microtubule-disrupting agent linked to an antibody targeting Nectin-4. In clinical trials, EV demonstrated high response rates and superior survival in the third-line setting for la/mUC compared with chemotherapy. Peripheral neuropathy and rash were among the most common serious adverse events. EV is currently approved in multiple countries for the treatment of la/mUC in the later-line setting. Ongoing trials seek to expand the indication for EV and to study therapeutic combinations with other agents.
Keywords: Padcev; antibody–drug conjugate; bladder cancer; enfortumab vedotin; locally advanced; metastatic; urothelial.
Enfortumab vedotin (EV) is a new drug recently approved for the treatment of advanced bladder cancer. In the past, treatment options for advanced bladder cancer were quite limited; therefore, the development and approval of EV was a major advance in the treatment of this disease. EV binds to a protein called Nectin-4, which is expressed by bladder cancer cells, to help kill the cancer cells. In an important clinical trial involving patients with advanced bladder cancer who had previously received other treatments, EV helped patients live longer compared with those who received chemotherapy. Serious side effects of EV can include peripheral neuropathy and rash. Future work is ongoing to expand the use of EV in patients with bladder and other cancers.