Dr. Ornstein on Enfortumab Vedotin in Advanced Urothelial Carcinoma

Moshe Ornstein, MD, MA, genitourinary medical oncologist, the Cleveland Clinic Taussig Cancer Institute, discusses the use of the antibody-drug conjugate (ADC) enfortumab vedotin-ejfv (Padcev) in patients with advanced urothelial carcinoma that is refractory to chemotherapy and immunotherapy.

Enfortumab vedotin targets nectin-4, an antibody that is present on most urothelial carcinoma cells, and is made up of monomethyl auristatin E, a microtubule-disrupting agent, Ornstein says. The agent works by finding nectin-4 on the surface of urothelial carcinoma cells and intracellularly inhibiting the microtubules, Ornstein explains.

Enfortumab vedotin is approved in patients with urothelial carcinoma who have previously been treated with immunotherapy, including cisplatin-ineligible patients, which has historically been a challenging population to treat, Ornstein notes. The adverse effects associated with the ADC include rash, which typically occurs early in treatment, and peripheral neuropathy, which is usually seen later in treatment, Ornstein concludes.