Antibody Drug Conjugates in Bladder Cancer: Current Milestones and Future Perspectives
Raafat Alameddine1, Patrick Mallea2, Farhan Shahab3
1Division of Hematology Oncology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
Opinion Statement:
Over the last several years, the treatment landscape of urothelial carcinoma has witnessed an unprecedented expansion of therapeutic options including checkpoint inhibitors, tyrosine kinase inhibitors, and antibody drug conjugates (ADC). Early trial data has shown that ADCs are safer and potentially effective treatment options in advanced bladder cancer as well as in the early disease. In particular, enfortumab-vedotin (EV) has shown promising results with a recent cohort of a clinical trial demonstrating that EV is effective as neoadjuvant monotherapy as well as in combination with pembrolizumab in metastatic setting. Similar promising results have been shown by other classes of ADC in other trials including sacituzumab-govitecan (SG) and oportuzumab monatox (OM). ADCs are likely to become a mainstay treatment option in the urothelial carcinoma playbook as either a monotherapy or combination therapy. The cost of the drug presents a real challenge, but further trial data may justify the use of the drug as mainstay treatment.
Insights
Antibody drug conjugates (ADCs) show promise as effective treatments for urothelial carcinoma, including advanced bladder cancer. While cost is a concern, ADCs are poised to become a standard therapy option.
Area of Science:
- Urothelial Carcinoma Treatment
- Oncology
- Pharmacology
Background:
- The treatment landscape for urothelial carcinoma has rapidly evolved.
- New therapeutic classes, including antibody drug conjugates (ADCs), have emerged.
- Early data suggests ADCs offer safety and efficacy in various stages of bladder cancer.
Purpose of the Study:
- To review the emerging role of antibody drug conjugates (ADCs) in urothelial carcinoma treatment.
- To highlight specific ADCs like enfortumab-vedotin (EV), sacituzumab-govitecan (SG), and oportuzumab monatox (OM).
- To discuss the potential of ADCs as a mainstay therapy in urothelial carcinoma management.
Main Methods:
- Review of recent clinical trial data and cohort studies.
- Analysis of therapeutic options including checkpoint inhibitors, tyrosine kinase inhibitors, and ADCs.
- Evaluation of safety and efficacy profiles of specific ADCs in urothelial carcinoma.
Main Results:
- Enfortumab-vedotin (EV) demonstrated effectiveness as neoadjuvant monotherapy and in combination with pembrolizumab.
- Other ADCs, such as sacituzumab-govitecan (SG) and oportuzumab monatox (OM), also show promising results.
- ADCs represent a potentially safer and effective treatment modality in both early and advanced urothelial carcinoma.
Conclusions:
- Antibody drug conjugates (ADCs) are likely to become a cornerstone of urothelial carcinoma treatment.
- ADCs may be utilized as monotherapy or in combination regimens.
- The cost of ADCs requires further evaluation, but clinical data supports their potential as a mainstay treatment.
