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  • Home
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Metastatic Bladder Cancer

Immunotherapy with atezolizumab (Tecentriq, Roche/Genentech) in combination with chemotherapy (CT) achieved a statistically longer median PFS of 8.2 months compared with 6.3 months for those receiving CT alone. (1) 

Patients with unresectable locally advanced or metastatic UCC who did not have disease progression after 1st line chemotherapy had an OS of 21.4mo when using avelumab vs. 14.3mo without. (6)
​
Enfortumab vedotin is an antibody-drug conjugate that targets Nectin-4, which is highly expressed in urothelial carcinoma.
​ (3). Half of patients with locally advanced or metastatic urothelial carcinoma who were treated with enfortumab vedotin (Padcev) monotherapy were alive at 12 months, according to data presented at the European Society of Medical Oncology Virtual Congress 2020 (4,5). 

Prognosis
One study found it node positive disease after cystectomy, the 5yr OS is 31% if received neoadjuvant, 26% if adjuvant, 19% in cystectomy alone, 14% in chemotherapy alone. (2)
  1. https://www.medscape.com/viewarticle/919192
  2. Galsky, Matthew D., et al. “Comparative Effectiveness of Treatment Strategies for Bladder Cancer With Clinical Evidence of Regional Lymph Node Involvement.” Journal of Clinical Oncology, vol. 34, no. 22, 2016, pp. 2627–2635.
  3. Rosenberg J, Sridhar SS, Zhang J, et al. EV-101: A Phase I Study of Single-Agent Enfortumab Vedotin in Patients With Nectin-4-Positive Solid Tumors, Including Metastatic Urothelial Carcinoma. J Clin Oncol. 2020;38(10):1041-1049. doi:10.1200/JCO.19.02044.
  4.  O’Donnell MD, Galsky JE, Petrylak DP, et al. EV-201: Long-term results of enfortumab vedotin monotherapy for locally advanced or metastatic urothelial caner previously treated with platinum and PD-1/PD-L1 inhibitors. Poster presented at: European Society of Medical Oncology Virtual Congress 2020; September 17-20, 2020. Abstract 746P.
  5. https://www.cancernetwork.com/view/enfortumab-vedotin-improves-os-in-patients-with-locally-advanced-metastatic-urothelial-carcinoma
  6. Powles, Thomas, et al. "Avelumab Maintenance Therapy for Advanced or Metastatic Urothelial Carcinoma." New England Journal of Medicine (2020).
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