Dr. Petrylak on Enfortumab Vedotin in Locally Advanced or Metastatic Urothelial Carcinoma

Daniel P. Petrylak, MD, professor of medicine and urology at Yale Cancer Center, 2017 Giant of Cancer Care^® in Genitourinary Cancers, discusses the phase II EV-201 trial of enfortumab vedotin in patients with locally advanced or metastatic urothelial cancer who were previously treated with platinum-based chemotherapy or a PD-1/PD-L1 checkpoint inhibitor.

Approximately 18,000 patients will die from metastatic urothelial cancer in 2019; unfortunately, only 1 in 4 patients benefit from checkpoint inhibition, leaving significant room for improvement in this field, Petrylak explains. A prior phase I trial of enfortumab vedotin showed a 45% overall response rate (ORR) in patients with metastatic disease, which justified an FDA breakthrough therapy designation of the agent.

In this trial, results showed a 44% ORR with a 38% response rate in the liver; the complete response rate was 12%. The agent was also well tolerated, and 12% of patients discontinued treatment due to adverse events. Moreover, a phase III trial is ongoing and is looking at enfortumab vedotin versus platinum-based chemotherapy in patients with metastatic urothelial cancer.

<<< 2019 ASCO Annual Meeting