Outcomes of metastatic urothelial carcinoma following discontinuation of enfortumab-vedotin

This retrospective study demonstrates poor outcomes of metastatic urothelial carcinoma patients following discontinuation of Enfortumab Vedotin (EV). Only 51% received therapy after discontinuation of EV. Benchmarks for the interpretation of activity of new agents following EV were identified. The duration of EV was identified as a potential prognostic factor following discontinuation of EV. Background: Enfortumab vedotin (EV) is approved to treat metastatic urothelial carcinoma (mUC) following platinum and PD1/L1 inhibitors. Since the outcomes and patterns of therapy of patients following discontinuation of EV are unknown, we conducted a retrospective study to assess this issue. Methods: Data were retrospectively obtained from patients with mUC following discontinuation of EV after prior platinum-based chemotherapy and PD1/L1 inhibitors. Objective response rate (ORR) was evaluated in those who received therapy post-EV. Statistical analyses were performed to describe the overall survival (OS) and compare patient characteristics and outcomes of those who did or did not receive treatment post-EV. Results: Data were available for 63 patients from 6 institutions: 46 (73%) were male and median age was 68 years (range 43-83). The median OS was 32 weeks. Thirty-two patients (51%) received therapy after EV. The OS of those who did vs. did not receive post-EV therapy was significantly different (median 43.1 vs. 16.9 weeks, P = .015). Longer duration of prior EV therapy was associated with receipt of post-EV therapy (P = .0437) as well as OS in both the treated (P = .045) and untreated groups (P = .012). Objective response was observed in 3 of 32 patients (9.4%) who received therapy post-EV. Conclusion: Outcomes of patients with mUC following discontinuation of EV are dismal and only 51% received therapy after discontinuation of EV. This study identifies benchmarks for the interpretation of activity of new agents following EV and raises the hypothesis for duration of EV as a potential prognostic factor following discontinuation of EV. (C) 2021 Elsevier Inc. All rights reserved.

Automated summary

This retrospective study highlights the poor outcomes of metastatic urothelial carcinoma patients following discontinuation of Enfortumab Vedotin (EV), with only 51% receiving therapy after discontinuation. It also identifies benchmarks for evaluating the activity of new agents after EV and suggests that the duration of EV may be a potential prognostic factor following discontinuation.