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Miyake M, Nishimura N, Oda Y, Miyamoto T, Ohmori C, Takamatsu N, Itami Y, Tachibana A, Matsumoto Y, Kiba K, Tomioka A, Yamamoto H, Okajima E, Masaomi K, Sakamoto K, Tomizawa M, Shimizu T, Ohnishi K, Hori S, Morizawa Y, Gotoh D, Nakai Y, Torimoto K, Tanaka N, Fujimoto K. 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; 54:329-338. [PMID: 38061911 DOI: 10.1093/jjco/hyad170] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 11/21/2023] [Indexed: 03/12/2024] Open
Abstract
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.
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Affiliation(s)
- Makito Miyake
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan
| | - Nobutaka Nishimura
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan
- Department of Urology, Hirao Hospital, Kashihara, Nara, Japan
| | - Yuki Oda
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan
| | | | - Chihiro Ohmori
- Department of Urology, Nara Prefecture General Medical Center, Nara, Nara, Japan
| | - Norimi Takamatsu
- Department of Urology, Yamatotakada Municipal Hospital, Yamatotakada, Nara, Japan
| | - Yoshitaka Itami
- Department of Urology, Tane General Hospital, Osaka, Osaka, Japan
| | - Akira Tachibana
- Department of Urology, Hoshigaoka Medical Center, Hirakata, Osaka, Japan
| | | | - Keisuke Kiba
- Department of Urology, Kindai University Nara Hospital, Ikoma, Nara, Japan
| | - Atsushi Tomioka
- Department of Urology, Saiseikai Chuwa Hospital, Sakurai, Nara, Japan
| | - Hiroaki Yamamoto
- Department of Urology, Minami Nara Medical Center, Yoshino, Nara, Japan
| | - Eijiro Okajima
- Department of Urology, Nara City Hospital, Nara, Nara, Japan
| | - Kuwata Masaomi
- Department of Urology, Matsusaka Chuo General Hospital, Matsusaka, Mie, Japan
| | - Keichi Sakamoto
- Department of Urology, Osaka Kaisei Hospital, Osaka, Osaka, Japan
| | - Mitsuru Tomizawa
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan
| | - Takuto Shimizu
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan
| | - Kenta Ohnishi
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan
| | - Shunta Hori
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan
| | - Yosuke Morizawa
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan
| | - Daisuke Gotoh
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan
| | - Yasushi Nakai
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan
| | - Kazumasa Torimoto
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan
| | - Nobumichi Tanaka
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan
- Department of Prostate Brachytherapy, Nara Medical University, Kashihara, Nara, Japan
| | - Kiyohide Fujimoto
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan
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