Outcomes of metastatic urothelial carcinoma following discontinuation of enfortumab-vedotin.
Catherine Curran, Elio Adib, Vera Kazakova, Petros Grivas, Leonidas Nikolaos Diamantopoulos, Ajjai Shivaram Alva, Christopher Su, Rohit K Jain, Ankita Tandon, Andrea Necchi, Laura Marandino, Trisha M Plastini, Jaime R Merchan, Guru Sonpavde
Author Information
Catherine Curran: Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA.
Elio Adib: Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA.
Vera Kazakova: St. Elizabeth's Medical Center, Brighton, MA.
Petros Grivas: University of Washington, Fred Hutchinson Cancer Research Center, Seattle Cancer Care Alliance, Seattle, WA.
Leonidas Nikolaos Diamantopoulos: University of Washington, Fred Hutchinson Cancer Research Center, Seattle Cancer Care Alliance, Seattle, WA; University of Pittsburgh Medical Center, Pittsburgh, PA.
Ajjai Shivaram Alva: University of Michigan Rogel Cancer Center, Ann Arbor, MI.
Christopher Su: University of Michigan Rogel Cancer Center, Ann Arbor, MI.
Rohit K Jain: H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL.
Ankita Tandon: H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL.
Andrea Necchi: Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Vita-Salute San Raffaele University and IRCCS San Raffaele Hospital, Milan, Italy.
Laura Marandino: Department of Oncology, University of Turin, Candiolo Cancer Institute-FPO-IRCCS, Candiolo, Italy.
Trisha M Plastini: University of Miami, Miami, FL.
Jaime R Merchan: University of Miami, Miami, FL.
Guru Sonpavde: Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA. Electronic address: gurup_sonpavde@dfci.harvard.edu.
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.
