enfortumab vedotin at a glance
Medicine class
Nectin-4-directed antibody–drug conjugate
Usual role
Treatment of specified muscle-invasive, unresectable, locally advanced or metastatic urothelial cancers
Administration
Intravenous infusion given by a specialist cancer team in a hospital or clinic
Key safety concerns
Severe skin reactions, high blood glucose, neuropathy, lung inflammation and serious infection
What is enfortumab vedotin used for?
Licensed uses in adults include:
With pembrolizumab before surgery and continued after radical cystectomy for resectable muscle-invasive bladder cancer when cisplatin-containing chemotherapy is unsuitable.
With pembrolizumab as first-line treatment for unresectable or metastatic urothelial cancer in people eligible for platinum-containing chemotherapy.
Alone for locally advanced or metastatic urothelial cancer previously treated with platinum-containing chemotherapy and a PD-1 or PD-L1 inhibitor.
How does enfortumab vedotin work?
The antibody binds to Nectin-4, a protein commonly found on urothelial cancer cells. The complex enters the cell and releases monomethyl auristatin E, which disrupts microtubules, stops cell division and promotes cancer-cell death.
enfortumab vedotin preparations and strengths
Solution for infusion
Route: Intravenous
Strengths: 20 mg, 30 mg
How to take enfortumab vedotin
Enfortumab vedotin is prepared and administered into a vein by trained healthcare professionals. It must not be given as a rapid intravenous injection. Tell staff promptly about pain, redness, itching or swelling at the infusion site, including symptoms developing after leaving the clinic.
Keep the patient card with you and show it to healthcare professionals.
Food does not affect administration because treatment is intravenous.
Do not drive or use machinery if treatment makes you feel unwell.
enfortumab vedotin side effects
Common or expected effects
- Tiredness, reduced appetite and weight loss
- Nausea, diarrhoea or vomiting
- Hair loss and altered taste
- Dry or itchy skin and rash
- Dry eyes
- Peripheral neuropathy, including tingling or numbness
- Anaemia
- Raised blood glucose or liver enzymes
Get urgent medical advice
- Severe blistering, peeling or ulcerating skin reactions, including Stevens–Johnson syndrome and toxic epidermal necrolysis
- Pneumonitis or interstitial lung disease causing new or worsening cough or breathlessness
- Severe hyperglycaemia or diabetic ketoacidosis
- Serious infection, including pneumonia or sepsis
- Worsening peripheral neuropathy or muscle weakness
- Infusion reaction or tissue injury from leakage around the infusion site
enfortumab vedotin in pregnancy
Enfortumab vedotin may harm an unborn baby and is not recommended during pregnancy. Pregnancy testing is recommended before treatment for people who could become pregnant. Effective contraception is advised during treatment and for at least 6 months afterwards; treated men should avoid fathering a child during treatment and for at least 4 months afterwards. Discuss fertility preservation with the specialist team before treatment where relevant.
enfortumab vedotin while breastfeeding
It is unknown whether enfortumab vedotin enters human milk, and harm to a breastfed child cannot be excluded. Breastfeeding should stop during treatment and for at least 6 months afterwards; discuss decisions with the oncology and maternity or breastfeeding team.
enfortumab vedotin interactions
Formal interaction studies are limited. The oncology team should review prescribed, over-the-counter and herbal products.
Strong CYP3A4 inhibitors, including clarithromycin, itraconazole, posaconazole, voriconazole, cobicistat and ritonavir
May increase exposure to the cytotoxic component; monitor more closely for toxicity.
Strong CYP3A4 inducers, including rifampicin, carbamazepine, phenobarbital and phenytoin
May reduce exposure to the cytotoxic component and potentially alter treatment effect.
St John’s wort
May reduce exposure to the cytotoxic component; tell the cancer team before using it.
Common questions about enfortumab vedotin
Answers are fully visible for fast scanning and source review.
What type of cancer is enfortumab vedotin used for?
It is licensed for specified forms of muscle-invasive, unresectable, locally advanced or metastatic urothelial cancer, including bladder cancer.
Is enfortumab vedotin chemotherapy?
It is an antibody–drug conjugate: a targeted antibody carries a potent cytotoxic agent to Nectin-4-expressing cells.
How is enfortumab vedotin given?
It is prepared and given into a vein by a specialist cancer team in a hospital or clinic.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.