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Enfortumab Vedotin in Urothelial Carcinoma

Antibody-drug conjugate targeting Nectin-4 for advanced bladder cancer

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Onkoloji department. Book Appointment →

What is Enfortumab Vedotin in Urothelial Carcinoma?

Enfortumab vedotin combines anti-Nectin-4 antibody with monomethyl auristatin E (MMAE) microtubule inhibitor payload connected through cleavable linker.

Nectin-4 is highly expressed on urothelial carcinoma cells with limited expression on normal tissues providing tumor selectivity.

Approved indications include monotherapy for advanced urothelial carcinoma after prior platinum and immune checkpoint inhibitor therapy.

Combination with pembrolizumab approved for first-line locally advanced or metastatic urothelial cancer.

Standard dosing administered intravenously on days 1, 8 and 15 of 28-day cycles.

Symptoms

Common adverse events include fatigue, alopecia, decreased appetite, peripheral neuropathy, dysgeusia and rash.
Skin toxicity ranges from mild rash to severe Stevens-Johnson syndrome and toxic epidermal necrolysis requiring vigilant assessment.
Hyperglycemia and new-onset diabetes can occur even in patients without prior diabetes.
Peripheral neuropathy with sensory and motor manifestations may become dose-limiting.
Pneumonitis and other immune-related events possible particularly in combination with checkpoint inhibitors.

Risk Factors

Pre-existing peripheral neuropathy may worsen significantly with treatment.
Diabetes mellitus or impaired glucose tolerance increases risk of severe hyperglycemia.
Skin disorders or photosensitivity may exacerbate cutaneous toxicity.
Pulmonary disease may increase risk of pneumonitis particularly in combination regimens.
Hepatic dysfunction may require dose modification.

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Skin reactions including blistering, peeling or mucous membrane involvement require immediate evaluation for severe cutaneous adverse reactions.
  • Symptoms of hyperglycemia (polyuria, polydipsia, weakness) require glucose evaluation.
  • Worsening neuropathy may require dose modification or discontinuation.
  • Respiratory symptoms in combination therapy require evaluation for pneumonitis.
  • Severe adverse events require treatment interruption and possible discontinuation.

Treatment Methods

01
Comprehensive baseline evaluation including skin examination, glucose assessment, neurologic evaluation and review of pre-existing neuropathy.
02
Patient education regarding skin care, photoprotection, glucose monitoring and neuropathy symptom recognition.
03
Routine monitoring with skin assessment, glucose checks, neurologic evaluation and complete blood count.
04
Symptomatic management with antihistamines for skin reactions, antidiabetic agents for hyperglycemia and neuropathy management.
05
Dose modifications, treatment interruption and discontinuation guided by toxicity grade with multidisciplinary care including oncology, dermatology, endocrinology and neurology along with consideration of treatment sequencing, response monitoring and combination strategies optimizes outcomes for this novel antibody-drug conjugate.

Which Department to Visit?

You can visit our Onkoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.