Administration of Enfortumab Vedotin after Immune-Checkpoint Inhibitor and the Prognosis in Japanese Metastatic Urothelial Carcinoma: A Large Database Study on Enfortumab Vedotin in Metastatic Urothelial Carcinoma

doi:10.3390/cancers15174227

. 2023 Aug 23;15(17):4227.

doi: 10.3390/cancers15174227.

Administration of Enfortumab Vedotin after Immune-Checkpoint Inhibitor and the Prognosis in Japanese Metastatic Urothelial Carcinoma: A Large Database Study on Enfortumab Vedotin in Metastatic Urothelial Carcinoma

Affiliations

¹ Departments of Urology and Renal Transplantation, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama 232-0024, Japan.
² Department of Urology, Graduate School of Medicine, Yokohama City University, Yokohama 236-0027, Japan.

PMID: 37686503
PMCID: PMC10486515
DOI: 10.3390/cancers15174227

Administration of Enfortumab Vedotin after Immune-Checkpoint Inhibitor and the Prognosis in Japanese Metastatic Urothelial Carcinoma: A Large Database Study on Enfortumab Vedotin in Metastatic Urothelial Carcinoma

Takashi Kawahara et al. Cancers (Basel). 2023.

. 2023 Aug 23;15(17):4227.

doi: 10.3390/cancers15174227.

Authors

Affiliations

¹ Departments of Urology and Renal Transplantation, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama 232-0024, Japan.
² Department of Urology, Graduate School of Medicine, Yokohama City University, Yokohama 236-0027, Japan.

PMID: 37686503
PMCID: PMC10486515
DOI: 10.3390/cancers15174227

Abstract

Background: Enfortumab vedotin shows promise as a targeted therapy for advanced urothelial carcinoma, particularly in patients who have previously received platinum-based chemotherapy and an immune-checkpoint inhibitor. The EV-301 phase III trial demonstrated significantly improved overall survival and response rates compared to standard chemotherapy. However, more data, especially from larger real-world studies, are needed to further assess its effectiveness in Japanese patients.

Methods: A total of 6007 urothelial cancer patients inducted with pembrolizumab as a second-line treatment were analyzed. Among them, 563 patients received enfortumab vedotin after pembrolizumab, while 443 patients received docetaxel or paclitaxel after pembrolizumab, and all were included in the study for efficacy as a life prolonging agent.

Results: The enfortumab vedotin group showed a longer overall survival than the paclitaxel/docetaxel group (p = 0.013, HR: 0.71). In multivariate analysis, enfortumab vedotin induction was the independent risk factor for overall survival (p = 0.013, HR: 0.70). There were no significant differences in cancer-specific survival.

Conclusions: Enfortumab vedotin prolonged the overall survival for Japanese advanced or metastatic urothelial carcinoma patients compared to paclitaxel or docetaxel after pembrolizumab treatment.

Keywords: database; enfortumab vedotin; immune checkpoint; real world; urothelial carcinoma.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

**Figure 2**
Kaplan–Meier Curve for overall survival: paclitaxel/docetaxel vs. enfortumab vedotin.

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[1] Alimohamed N., Grewal S., Wirtz H.S., Hepp Z., Sauvageau S., Boyne D.J., Brenner D.R., Cheung W.Y., Jarada T.N. Understanding Treatment Patterns and Outcomes among Patients with De Novo Unresectable Locally Advanced or Metastatic Urothelial Cancer: A Population-Level Retrospective Analysis from Alberta, Canada. Curr. Oncol. 2022;29:7587–7597. doi: 10.3390/curroncol29100599. - DOI - PMC - PubMed

[2] Alimohamed N., Grewal S., Wirtz H.S., Hepp Z., Sauvageau S., Boyne D.J., Brenner D.R., Cheung W.Y., Jarada T.N. Understanding Treatment Patterns and Outcomes among Patients with De Novo Unresectable Locally Advanced or Metastatic Urothelial Cancer: A Population-Level Retrospective Analysis from Alberta, Canada. Curr. Oncol. 2022;29:7587–7597. doi: 10.3390/curroncol29100599. - DOI - PMC - PubMed

[3] Torre L.A., Bray F., Siegel R.L., Ferlay J., Lortet-Tieulent J., Jemal A. Global cancer statistics, 2012. CA Cancer J. Clin. 2015;65:87–108. doi: 10.3322/caac.21262. - DOI - PubMed

[4] Torre L.A., Bray F., Siegel R.L., Ferlay J., Lortet-Tieulent J., Jemal A. Global cancer statistics, 2012. CA Cancer J. Clin. 2015;65:87–108. doi: 10.3322/caac.21262. - DOI - PubMed

[5] Witjes J.A., Lebret T., Compérat E.M., Cowan N.C., De Santis M., Bruins H.M., Hernández V., Espinós E.L., Dunn J., Rouanne M., et al. Updated 2016 EAU Guidelines on Muscle-Invasive and Metastatic Bladder Cancer. Eur. Urol. 2017;71:462–475. doi: 10.1016/j.eururo.2016.06.020. - DOI - PubMed

[6] Witjes J.A., Lebret T., Compérat E.M., Cowan N.C., De Santis M., Bruins H.M., Hernández V., Espinós E.L., Dunn J., Rouanne M., et al. Updated 2016 EAU Guidelines on Muscle-Invasive and Metastatic Bladder Cancer. Eur. Urol. 2017;71:462–475. doi: 10.1016/j.eururo.2016.06.020. - DOI - PubMed

[7] Maas M., Stühler V., Walz S., Stenzl A., Bedke J. Enfortumab vedotin—Next game-changer in urothelial cancer. Expert Opin. Biol. Ther. 2021;21:801–809. doi: 10.1080/14712598.2021.1865910. - DOI - PubMed

[8] Maas M., Stühler V., Walz S., Stenzl A., Bedke J. Enfortumab vedotin—Next game-changer in urothelial cancer. Expert Opin. Biol. Ther. 2021;21:801–809. doi: 10.1080/14712598.2021.1865910. - DOI - PubMed

[9] Bellmunt J., De Wit R., Vaughn D.J., Fradet Y., Lee J.-L., Fong L., Vogelzang N.J., Climent M.A., Petrylak D.P., Choueiri T.K., et al. Pembrolizumab as Second-Line Therapy for Advanced Urothelial Carcinoma. N. Engl. J. Med. 2017;376:1015–1026. doi: 10.1056/NEJMoa1613683. - DOI - PMC - PubMed

[10] Bellmunt J., De Wit R., Vaughn D.J., Fradet Y., Lee J.-L., Fong L., Vogelzang N.J., Climent M.A., Petrylak D.P., Choueiri T.K., et al. Pembrolizumab as Second-Line Therapy for Advanced Urothelial Carcinoma. N. Engl. J. Med. 2017;376:1015–1026. doi: 10.1056/NEJMoa1613683. - DOI - PMC - PubMed

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Administration of Enfortumab Vedotin after Immune-Checkpoint Inhibitor and the Prognosis in Japanese Metastatic Urothelial Carcinoma: A Large Database Study on Enfortumab Vedotin in Metastatic Urothelial Carcinoma

Affiliations

Administration of Enfortumab Vedotin after Immune-Checkpoint Inhibitor and the Prognosis in Japanese Metastatic Urothelial Carcinoma: A Large Database Study on Enfortumab Vedotin in Metastatic Urothelial Carcinoma

Authors

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Abstract

Conflict of interest statement

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Abstract

Conflict of interest statement

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