Enfortumab Vedotin With or Without Pembrolizumab in Metastatic Urothelial Carcinoma

JAMA Network Open, Journal Year: 2025, Volume and Issue: 8(3), P. e250250 - e250250

Published: March 11, 2025

Importance Metastatic urothelial carcinoma (mUC) presents a therapeutic challenge with poor outcome. Enfortumab vedotin has emerged as promising treatment, necessitating comprehensive evaluation of its effectiveness and safety. Objective To synthesize the available evidence on enfortumab vedotin, both monotherapy in combination pembrolizumab, an mUC treatment for purpose guiding clinical decision-making future research. Data Sources Cochrane Library, MEDLINE (via PubMed), Google Scholar, Web Science were searched from database inception to August 31, 2024. Major conference abstracts 2019 2024 also included. Search strategy used Medical Subject Heading terms free-text keywords related vedotin. Study Selection Randomized trials prospective studies investigating adult patients Eleven met inclusion criteria. Extraction Synthesis Two independent reviewers extracted data assessed study quality using Risk Bias tool 2 Non-Randomized Studies Interventions tool. The meta-analysis random effects model, while network was performed frequentist approach. Main Outcomes Measures Primary outcomes disease control rate (DCR), objective response (ORR), 1-year survival rate. Results 11 included (3 randomized [27.3%] 8 nonrandomized [72.7%]) involved 2128 patients. Of these patients, 563 (26.5%) received plus 814 (38.3%) without 751 (35.3%) chemotherapy. pembrolizumab associated pooled DCR 86% (95% CI, 83%-89%), ORR 68% 64%-71%), 79% 75%-82%). had 73% 70%-76%), 43% 40%-47%), 52% 48%-56%). Network revealed that significantly outperformed chemotherapy (odds ratio [OR], 3.47; 95% 1.49-8.09; P = .004) (OR, 2.32; 1.75-3.06; < .001). Conclusions Relevance In this systematic review meta-analysis, showed high rates first-line settings, benefit later lines therapy. These findings underscore importance personalized approaches, research is warranted refine vedotin–based therapies management.

Language: Английский

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Case Report: Pembrolizumab in a patient with preexisting paraneoplastic dermatomyositis and sarcomatoid urothelial carcinoma. Searching for balance

Frontiers in Immunology, Journal Year: 2025, Volume and Issue: 16

Published: March 17, 2025

Dermatomyositis (DM) is an uncommon systemic autoimmune disorder classified as one of the idiopathic inflammatory myopathies (IIM). DM could also represent a manifestation underlying neoplasm with relative risk cancer globally ranging from 3% to 8%. Owing strong connection between immunosurveillance and progression, management paraneoplastic represents challenging issue. To complicate matters advent immunotherapy, that might interfere self-tolerance true previous disorders re-exacerbation. We report case 50-year-old patient advanced urothelial bladder preexisting treated pembrolizumab. On basis our experience, not necessarily absolute contraindication for ICIs treatment. Furthermore, this suggest role intravenous immunoglobulins (IVIG) in preventing reactivation, underling importance multidisciplinary approach.

Language: Английский

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Toxicities and management strategies of emerging antibody–drug conjugates in breast cancer

Therapeutic Advances in Medical Oncology, Journal Year: 2025, Volume and Issue: 17

Published: Jan. 1, 2025

Antibody–drug conjugates (ADCs) offer a promising therapeutic approach for various cancers, enhancing the window while mitigating systemic adverse effects on healthy tissues. ADCs have achieved remarkable clinical success, particularly in treating breast cancer, becoming standard therapy across all subtypes, including hormone receptor-positive, human epidermal growth factor receptor 2-positive, and triple-negative cancer. Although designed to selectively target antigens via monoclonal antibodies, can exhibit toxicity normal tissues, often due off-target of their cytotoxic payloads. Understanding managing these toxicities according established guidelines are crucial ADC efficacy, minimizing events, ultimately improving patient outcomes. This review comprehensively examines employed cancer treatment explores management strategies. Furthermore, we investigate novel beyond trastuzumab deruxtecan sacituzumab govitecan, evaluating potential efficacy corresponding safety profiles.

Language: Английский

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Enfortumab vedotin and pembrolizumab: redefining the standard of care for previously untreated advanced urothelial cancer

Future Oncology, Journal Year: 2025, Volume and Issue: unknown, P. 1 - 16

Published: March 25, 2025

Combination treatment with Enfortumab vedotin (EV), an antibody drug conjugate targeting Nectin-4 a monomethyl auristatin E (MMAE) payload, and pembrolizumab, programmed death 1 (PD-1) inhibitor, has become the new standard of care for previously untreated locally advanced or metastatic urothelial carcinoma. In recently published phase III study, EV-302, EV pembrolizumab demonstrated improved outcomes compared to platinum-based chemotherapy, including objective response rate, progression free survival, unprecedented median overall survival 33.8 months (versus 15.9 months; hazard ratio 0.51; 95% confidence interval 0.43–0.61; p < 0.00001). We reviewed mechanism action, clinical efficacy, exploratory biomarkers, safety profile as monotherapies combination in cancer.

Language: Английский

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Efficacy and safety of routine corticosteroid premedication in enfortumab vedotin therapy for advanced urothelial carcinoma

International Urology and Nephrology, Journal Year: 2025, Volume and Issue: unknown

Published: March 26, 2025

Language: Английский

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