AI Article Synopsis

  • - The study investigates the effects of enfortumab vedotin, a new treatment for urothelial cancer, focusing on how peripheral neuropathy impacts its effectiveness and if early nerve changes are linked to neuropathy onset.
  • - In a trial involving 34 patients with advanced bladder cancer who had not responded to previous therapies, the treatment showed promising results with a 52.9% overall response rate and significant survival benefits.
  • - Peripheral neuropathy was present in 12.5% of patients, but interestingly, those affected had better response rates compared to those without neuropathy; nerve studies showed that sensory nerves were more impacted, particularly the sural nerve.

Article Abstract

Background: Enfortumab vedotin is a novel antibody-drug conjugate used as a third-line therapy for the treatment of urothelial cancer. We aimed to elucidate the effect of enfortumab vedotin-related peripheral neuropathy on its efficacy and whether enfortumab vedotin-induced early electrophysiological changes could be associated with peripheral neuropathy onset.

Methods: Our prospective multicenter cohort study enrolled 34 patients with prior platinum-containing chemotherapy and programmed cell death protein 1/ligand 1 inhibitor-resistant advanced urothelial carcinoma and received enfortumab vedotin. The best overall response, progression-free survival, overall survival, and safety were assessed. Nerve conduction studies were also performed in 11 patients.

Results: The confirmed overall response rate and disease control rate were 52.9% and 73.5%, respectively. The median overall progression-free survival and overall survival were 6.9 and 13.5 months, respectively, during a median follow-up of 8.6 months. The patients with disease control had significantly longer treatment continuation and overall survival than did those with uncontrolled disease. Peripheral neuropathy occurred in 12.5% of the patients. The overall response and disease control rates were 83.3% and 100%, respectively: higher than those in patients without peripheral neuropathy (p = 0.028 and p = 0.029, respectively). Nerve conduction studies indicated that enfortumab vedotin reduced nerve conduction velocity more markedly in sensory nerves than in motor nerves and the lower limbs than in the upper limbs, with the sural nerve being the most affected in the patients who developed peripheral neuropathy (p = 0.011).

Conclusion: Our results indicated the importance of focusing on enfortumab vedotin-induced neuropathy of the sural nerve to maximize efficacy and improve safety.

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Source
http://dx.doi.org/10.1007/s10147-024-02481-8DOI Listing

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