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Organ-Specific Tumor Response to Enfortumab Vedotin for Metastatic Urothelial Carcinoma: A Multicenter Retrospective
Akinori Minato1, Nobuki Furubayashi2, Toshihisa Tomoda3
1Department of Urology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
Introduction:
To evaluate the organ-specific therapeutic effect of enfortumab vedotin (EV) after chemotherapy and immunotherapy failed for advanced urothelial carcinoma.
Materials Methods:
At 6 institutions between December 2021 and July 2023, we retrospectively analyzed patients with metastatic upper and lower urinary tract cancer who received EV monotherapy after platinum-based chemotherapy and immune checkpoint blockade therapy. Objective response rate (ORR) and organ-specific response rate (OSRR) were evaluated according to the Response Evaluation Criteria in Solid Tumors, version 1.1.
Results:
This study analyzed 58 patients with 210 tumor lesions, of which 24% were females and 48% had upper urinary tract cancer. The ORR and disease control rate were 53.5% and 74.1%. Moreover, we found 15 target lesions in the primary site, 7 in local recurrence, 93 in the lymph nodes, 46 in the lung, 29 in the liver, and 20 in the bone, with OSRRs of 40%, 71.4%, 61.1%, 70.6%, 90.9%, and 18.2%, respectively. Over time from baseline, the reduction rate (median) in tumor burden was 50% or more in the lymph node, lung, and liver metastases.
Conclusion:
The organ-specific tumor response to EV in patients with metastatic urothelial carcinoma was almost favorable. The antitumor activity of EV monotherapy may be less in bone metastasis than in other organ sites. Conversely, EV showed remarkably high efficacy against liver metastasis.
Insights
Enfortumab vedotin (EV) shows favorable organ-specific responses in advanced urothelial carcinoma patients who failed prior therapies. EV demonstrated high efficacy against liver metastases but less activity in bone metastases.
Area of Science:
- Oncology
- Medical Research
- Clinical Trials
Background:
- Advanced urothelial carcinoma often necessitates salvage therapy after initial treatments fail.
- Chemotherapy and immunotherapy resistance presents a significant clinical challenge.
Purpose of the Study:
- To assess the organ-specific therapeutic efficacy of enfortumab vedotin (EV) as a monotherapy.
- To evaluate EV's effectiveness in patients with metastatic urothelial carcinoma refractory to chemotherapy and immunotherapy.
Main Methods:
- Retrospective analysis of 58 patients with metastatic urothelial carcinoma across 6 institutions.
- EV monotherapy administered after failure of platinum-based chemotherapy and immune checkpoint inhibitors.
- Evaluation of objective response rate (ORR) and organ-specific response rates (OSRR) using RECIST v1.1 criteria.
Main Results:
- Overall ORR was 53.5% with a disease control rate of 74.1%.
- High OSRRs were observed in liver (90.9%) and lung (70.6%) metastases.
- Lower efficacy was noted in bone metastases (18.2%), while lymph node and primary site responses were also favorable.
Conclusions:
- Enfortumab vedotin exhibits significant organ-specific antitumor activity in heavily pre-treated urothelial carcinoma.
- EV demonstrates remarkable efficacy against liver metastases, suggesting a potential role in targeted organ management.
- Bone metastases appear less responsive to EV monotherapy compared to other sites.
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