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Background <p>Enfortumab vedotin (EV) is a novel treatment for metastatic urothelial carcinoma (mUC) that progresses after platinum-based chemotherapy and PD-1/PD-L1 inhibitor therapy. This study aimed to compare the efficacy of EV with that of paclitaxel plus carboplatin therapy (TC), which was commonly used as late-line therapy.</p> Methods <p>This retrospective study included patients with mUC who progressed after platinum-based chemotherapy and PD-1/PD-L1 inhibitor therapy. Patients were classified into two groups: those who were initiated on EV (EV group) and those who received TC as the next-line treatment (TC group). Therapeutic efficacy and adverse events (AEs) were investigated.</p> Results <p>A total of 55 patients were included in this study (20 in the TC group and 35 in the EV group). The EV group had significantly better progression-free survival (PFS) (<i>p</i> = 0.0013) and overall survival (OS) (<i>p</i> = 0.0279) than the TC group. The most frequent AEs were neutropenia (70.0%), febrile neutropenia (20.0%), and peripheral neuropathy (20.0%) in the TC group and pruritus (45.7%) and maculopapular rash (37.1%) in the EV group. Patients who progressed after EV administration were classified into two groups: those who received TC (the TC group) and those who were shifted to best supportive care (the BSC group). The TC group had significantly better OS (<i>p</i> = 0.0084).</p> Conclusions <p>EV was associated with significantly better PFS and OS than TC in patients with mUC who progressed after platinum-based chemotherapy and PD-1/PD-L1 inhibitor therapy. TC is beneficial for certain patients, even in cases of progression after EV administration.</p>

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Comparison of the efficacy of enfortumab vedotin and paclitaxel plus carboplatin in patients with metastatic urothelial carcinoma

  • 期刊论文

  • 发表日期：

    2025年1月19日

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  • Ryunosuke Nakagawa,
  • Kouji Izumi,
  • Ren Toriumi,
  • Shuhei Aoyama,
  • Hiroshi Kano,
  • Tomoyuki Makino,
  • Renato Naito,
  • Suguru Kadomoto,
  • Hiroaki Iwamoto,
  • Hiroshi Yaegashi,
  • Shohei Kawaguchi,
  • Takahiro Nohara,
  • Kazuyoshi Shigehara,
  • Atsushi Mizokami

摘要

Background

Enfortumab vedotin (EV) is a novel treatment for metastatic urothelial carcinoma (mUC) that progresses after platinum-based chemotherapy and PD-1/PD-L1 inhibitor therapy. This study aimed to compare the efficacy of EV with that of paclitaxel plus carboplatin therapy (TC), which was commonly used as late-line therapy.

Methods

This retrospective study included patients with mUC who progressed after platinum-based chemotherapy and PD-1/PD-L1 inhibitor therapy. Patients were classified into two groups: those who were initiated on EV (EV group) and those who received TC as the next-line treatment (TC group). Therapeutic efficacy and adverse events (AEs) were investigated.

Results

A total of 55 patients were included in this study (20 in the TC group and 35 in the EV group). The EV group had significantly better progression-free survival (PFS) (p = 0.0013) and overall survival (OS) (p = 0.0279) than the TC group. The most frequent AEs were neutropenia (70.0%), febrile neutropenia (20.0%), and peripheral neuropathy (20.0%) in the TC group and pruritus (45.7%) and maculopapular rash (37.1%) in the EV group. Patients who progressed after EV administration were classified into two groups: those who received TC (the TC group) and those who were shifted to best supportive care (the BSC group). The TC group had significantly better OS (p = 0.0084).

Conclusions

EV was associated with significantly better PFS and OS than TC in patients with mUC who progressed after platinum-based chemotherapy and PD-1/PD-L1 inhibitor therapy. TC is beneficial for certain patients, even in cases of progression after EV administration.