enfortumab-vedotin

Overview

Nectin-4-directed antibody-drug conjugate delivering the microtubule disruptor MMAE; cited as an alternative systemic option in metastatic urothelial carcinoma (PMID:37682528).

Evidence in the corpus

• Referenced as an alternative line of therapy for metastatic urothelial carcinoma in the context of the modest real-world activity (ORR 40%, PFS 2.8 mo) and tolerability burden of erdafitinib in FGFR3-altered disease (PMID:37682528).
• In the CALGB 90601 cfDNA biomarker study (n=201 mUC patients), enfortumab vedotin + pembrolizumab is cited as the current first-line standard of care for metastatic urothelial carcinoma that has supplanted gemcitabine/cisplatin. The authors note that gemcitabine/cisplatin remains relevant as a second-line option after EV+pembrolizumab, keeping cisplatin-based biomarkers (TERT, PIK3CA, ERBB2, VAF) clinically actionable. PMID:40256659

Resistance mechanisms

• Not characterized in the corpus.

Cancer types (linked)

• BLCA
• UTUC

Sources

• PMID:37682528
• PMID:40256659 — Guercio et al. (2025). CALGB 90601 cfDNA study; EV+pembrolizumab cited as supplanting cisplatin-based first-line therapy in mUC, contextualizing the clinical relevance of the biomarker findings.

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