Response Duration After Stopping Enfortumab Vedotin in Bladder Cancer

Patients with metastatic urothelial carcinoma who achieved a complete response after more than 8.5 months of single-agent enfortumab vedotin (Padcev) were able to be off treatment for over 2 years before needing to restart therapy, according to retrospective data presented at the recent European Society for Medical Oncology annual congress in Barcelona.

In this exclusive MedPage Today video, Jonathan Rosenberg, MD, of Memorial Sloan Kettering (MSK) Cancer Center in New York City, discusses the implications of these findings.

Following is a transcript of his remarks:

Many patients develop neuropathy and other toxicities that require cessation of treatment while they’re still in response, either with stable disease or partial or a complete response. And what we showed is that patients who have a complete response or patients who were on treatment for more than 8 months, we saw that they could be off treatment for at least 2, if not 2 years or longer. The patients who stopped in response could stay off for 2 and a half years. Patients who were on longer were able to stay off longer.

And so while there seems to be an impetus to reduce treatment duration for enfortumab in responders, I actually wonder whether or not that is the right move and whether patients who are responding might need to be maintained on treatment a little longer to maximally cyto-reduce and to get more durable remissions.

This was a retrospective data set of 57 patients treated at MSK, who met the criteria for stable disease or better and had to stop enfortumab vedotin for toxicity or for other reasons.

And these data are really quite interesting and impressive that if you don’t progress and that your time on [enfortumab vedotin] is more than 8 and a half months and you have a response, you can be off for about 2 and a half years before needing to restart.

So we look forward to seeing more long-term data in some of these subsets. I think this is practice-informing in terms of how we’re treating our patients, and that perhaps we shouldn’t be too quick to stop enfortumab in responding patients. And that a longer duration of therapy beyond 6 months, but maybe not beyond a year, might be helpful in allowing those patients to have meaningful time of therapy without progression.

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