Enfortumab vedotin following platinum-based chemotherapy and immune checkpoint inhibitors for advanced urothelial carcinoma: response, survival and safety analysis from a multicentre real-world Japanese cohort

Jpn J Clin Oncol. 2024 Mar 9;54(3):329-338. doi: 10.1093/jjco/hyad170.


Objective: Real-world evidence regarding enfortumab vedotin for unresectable or metastatic urothelial carcinoma is scarce, particularly in Japan. We investigated real-world data focusing on patient background, previous treatments, response, survival and adverse events in patients receiving enfortumab vedotin.

Methods: A multicentre database was used to register 556 patients diagnosed with metastatic urothelial carcinoma from 2008 to 2023; 34 patients (6.1%) treated with enfortumab vedotin were included. Best radiographic objective responses were evaluated using the Response Evaluation Criteria in Solid Tumors (v1.1) during treatments. Overall survival and progression-free survival were estimated (Kaplan-Meier method). Toxicities were reported according to the Common Terminology Criteria for Adverse Events, version 5.0. The relative dose intensity, which could impact oncological outcomes, was calculated.

Results: The median number of enfortumab vedotin therapy cycles was 5. The best objective response to enfortumab vedotin was partial response, stable disease and progressive disease in 19 (56%), 5 (15%) and 10 (29%) patients, respectively. The median overall survival and progression-free survival after the first enfortumab vedotin dose were 16 and 9 months, respectively. No significant relationship was observed between survival outcomes after enfortumab vedotin initiation and the enfortumab vedotin relative dose intensity. The median overall survival from first-line platinum-based chemotherapy initiation was 42 months. Twenty-six (76%) patients experienced any grade of enfortumab vedotin-related toxicities; eight (24%) experienced Grades 3-4 toxicities, the most common being skin toxicity (any grade, 47%; Grades 3-4, 12%).

Conclusions: Here, we report real-world evidence for enfortumab vedotin therapy in Japan. Tumour responses and safety profiles were comparable with those of clinical trials on this novel treatment.

Keywords: avelumab; chemotherapy; enfortumab vedotin; immunotherapy; kidney pelvis; mortality; pembrolizumab; survival; ureter; urinary bladder neoplasms.

Publication types

  • Multicenter Study

MeSH terms

  • Antibodies, Monoclonal*
  • Carcinoma, Transitional Cell* / drug therapy
  • Humans
  • Immune Checkpoint Inhibitors / therapeutic use
  • Japan
  • Platinum / therapeutic use
  • Urinary Bladder Neoplasms* / pathology


  • enfortumab vedotin
  • Immune Checkpoint Inhibitors
  • Platinum
  • Antibodies, Monoclonal