Treatment Optimization and Management of AEs with Enfortumab Vedotin + Pembrolizumab for Untreated Locally Advanced/Metastatic Urothelial Cancer: A Podcast

In the EV-302/KEYNOTE-A39 trial (NCT04223856), enfortumab vedotin + pembrolizumab (EV + P) became the first treatment in decades to demonstrate significant survival benefit compared with platinum-based chemotherapy in the first-line setting for patients with locally advanced or metastatic urothelial cancer. The safety profile of EV + P in EV-302/KEYNOTE-A39 was consistent with previous clinical studies and with the expected safety profiles of each agent alone; however, real-world experience in the management of adverse events (AEs) resulting from treatment with EV + P in patients with locally advanced or metastatic urothelial cancer is still evolving. Historically, healthcare professionals have been familiar with the management of EV and pembrolizumab as monotherapies, with guidance available for management of AEs with either drug alone. However, management of AEs with EV + P can sometimes be more complex since some of the AEs associated with EV also occur with pembrolizumab. Such AEs include skin reactions, hyperglycemia, and pneumonitis, all of which have been reported with either therapy alone and with increased incidence with the combination. In this podcast, we discuss the management of AEs with EV + P on the basis of our personal experiences with clinical trials and in our practices and provide perspectives for healthcare professionals on practical management of common AEs and effective dose management strategies. This may help improve the patient experience and allow patients to stay on therapy for longer, leading to optimized treatment outcomes. Podcast video (MP4 3,14,449 kb).