Cargando…
First Evidence of Activity of Enfortumab Vedotin on Brain Metastases in Urothelial Cancer Patients
Enfortumab vedotin (EV), an antibody–drug conjugate directed against Nectin-4, significantly prolonged survival compared to standard chemotherapy in patients with locally advanced or metastatic urothelial carcinoma who previously received platinum-based chemotherapy and a PD-1 or PD-L1 inhibitor. Th...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10057070/ https://www.ncbi.nlm.nih.gov/pubmed/36986475 http://dx.doi.org/10.3390/ph16030375 |
_version_ | 1785016273051058176 |
---|---|
author | Vulsteke, Christof De Cocker, Laurens Gómez de Liaño, Alfonso Montesdeoca, Cristina De Meulenaere, Astrid Croes, Lieselot Delombaerde, Danielle Szabados, Bernadett Powles, Thomas |
author_facet | Vulsteke, Christof De Cocker, Laurens Gómez de Liaño, Alfonso Montesdeoca, Cristina De Meulenaere, Astrid Croes, Lieselot Delombaerde, Danielle Szabados, Bernadett Powles, Thomas |
author_sort | Vulsteke, Christof |
collection | PubMed |
description | Enfortumab vedotin (EV), an antibody–drug conjugate directed against Nectin-4, significantly prolonged survival compared to standard chemotherapy in patients with locally advanced or metastatic urothelial carcinoma who previously received platinum-based chemotherapy and a PD-1 or PD-L1 inhibitor. The overall response rate in the phase 3 EV301 trial leading to approval was 40.6%. However, no data have been published yet regarding the effect of EV on brain metastases. Here, we present three patients from different centers with brain metastases receiving EV. A 58-year-old white male patient, who had been heavily pretreated for urothelial carcinoma with visceral metastases and a solitary clinically active brain metastasis, started on EV 1.25 mg/kg on days 1, 8, and 15 of a 28-day cycle. After three cycles, the first evaluation showed a partial remission by RECIST v1.1, with a near complete response on the brain metastasis and disappearance of neurological symptoms. The patient is currently still receiving EV. A second, 74-year-old male patient started on the same regimen, after previous progression on platinum-based chemotherapy and avelumab in maintenance. The patient achieved a complete response and received therapy for five months. Nevertheless, therapy was discontinued at the patient’s request. Shortly after, he developed new leptomeningeal metastases. Upon rechallenge with EV, there was a significant reduction in the diffuse meningeal infiltration. A third, 50-year-old white male patient also received EV after previous progression on cisplatin–gemcitabine and atezolizumab maintenance, followed by palliative whole-brain radiotherapy and two cycles of vinflunine. After three cycles of EV, there was a significant reduction in the brain metastases. The patient is currently still receiving EV. These are the first reports on the efficacy of EV in patients with urothelial carcinoma and active brain metastases. |
format | Online Article Text |
id | pubmed-10057070 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-100570702023-03-30 First Evidence of Activity of Enfortumab Vedotin on Brain Metastases in Urothelial Cancer Patients Vulsteke, Christof De Cocker, Laurens Gómez de Liaño, Alfonso Montesdeoca, Cristina De Meulenaere, Astrid Croes, Lieselot Delombaerde, Danielle Szabados, Bernadett Powles, Thomas Pharmaceuticals (Basel) Case Report Enfortumab vedotin (EV), an antibody–drug conjugate directed against Nectin-4, significantly prolonged survival compared to standard chemotherapy in patients with locally advanced or metastatic urothelial carcinoma who previously received platinum-based chemotherapy and a PD-1 or PD-L1 inhibitor. The overall response rate in the phase 3 EV301 trial leading to approval was 40.6%. However, no data have been published yet regarding the effect of EV on brain metastases. Here, we present three patients from different centers with brain metastases receiving EV. A 58-year-old white male patient, who had been heavily pretreated for urothelial carcinoma with visceral metastases and a solitary clinically active brain metastasis, started on EV 1.25 mg/kg on days 1, 8, and 15 of a 28-day cycle. After three cycles, the first evaluation showed a partial remission by RECIST v1.1, with a near complete response on the brain metastasis and disappearance of neurological symptoms. The patient is currently still receiving EV. A second, 74-year-old male patient started on the same regimen, after previous progression on platinum-based chemotherapy and avelumab in maintenance. The patient achieved a complete response and received therapy for five months. Nevertheless, therapy was discontinued at the patient’s request. Shortly after, he developed new leptomeningeal metastases. Upon rechallenge with EV, there was a significant reduction in the diffuse meningeal infiltration. A third, 50-year-old white male patient also received EV after previous progression on cisplatin–gemcitabine and atezolizumab maintenance, followed by palliative whole-brain radiotherapy and two cycles of vinflunine. After three cycles of EV, there was a significant reduction in the brain metastases. The patient is currently still receiving EV. These are the first reports on the efficacy of EV in patients with urothelial carcinoma and active brain metastases. MDPI 2023-03-01 /pmc/articles/PMC10057070/ /pubmed/36986475 http://dx.doi.org/10.3390/ph16030375 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Case Report Vulsteke, Christof De Cocker, Laurens Gómez de Liaño, Alfonso Montesdeoca, Cristina De Meulenaere, Astrid Croes, Lieselot Delombaerde, Danielle Szabados, Bernadett Powles, Thomas First Evidence of Activity of Enfortumab Vedotin on Brain Metastases in Urothelial Cancer Patients |
title | First Evidence of Activity of Enfortumab Vedotin on Brain Metastases in Urothelial Cancer Patients |
title_full | First Evidence of Activity of Enfortumab Vedotin on Brain Metastases in Urothelial Cancer Patients |
title_fullStr | First Evidence of Activity of Enfortumab Vedotin on Brain Metastases in Urothelial Cancer Patients |
title_full_unstemmed | First Evidence of Activity of Enfortumab Vedotin on Brain Metastases in Urothelial Cancer Patients |
title_short | First Evidence of Activity of Enfortumab Vedotin on Brain Metastases in Urothelial Cancer Patients |
title_sort | first evidence of activity of enfortumab vedotin on brain metastases in urothelial cancer patients |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10057070/ https://www.ncbi.nlm.nih.gov/pubmed/36986475 http://dx.doi.org/10.3390/ph16030375 |
work_keys_str_mv | AT vulstekechristof firstevidenceofactivityofenfortumabvedotinonbrainmetastasesinurothelialcancerpatients AT decockerlaurens firstevidenceofactivityofenfortumabvedotinonbrainmetastasesinurothelialcancerpatients AT gomezdelianoalfonso firstevidenceofactivityofenfortumabvedotinonbrainmetastasesinurothelialcancerpatients AT montesdeocacristina firstevidenceofactivityofenfortumabvedotinonbrainmetastasesinurothelialcancerpatients AT demeulenaereastrid firstevidenceofactivityofenfortumabvedotinonbrainmetastasesinurothelialcancerpatients AT croeslieselot firstevidenceofactivityofenfortumabvedotinonbrainmetastasesinurothelialcancerpatients AT delombaerdedanielle firstevidenceofactivityofenfortumabvedotinonbrainmetastasesinurothelialcancerpatients AT szabadosbernadett firstevidenceofactivityofenfortumabvedotinonbrainmetastasesinurothelialcancerpatients AT powlesthomas firstevidenceofactivityofenfortumabvedotinonbrainmetastasesinurothelialcancerpatients |