Enfortumab Vedotin and Pembrolizumab — A New Perspective on Urothelial Cancer

This editorial discusses the landmark EV 302 phase 3 trial comparing enfortumab vedotin plus pembrolizumab to platinum based chemotherapy in patients with untreated locally advanced or metastatic urothelial carcinoma. The combination therapy significantly improved progression-free survival (50.7% vs. 21.6% at 1 year) and overall survival (median 31.5 vs. 16.1 months), with a 67.7% response rate. Benefits were consistent across subgroups regardless of cisplatin eligibility or PD L1 status. The editorial highlights the shift in standard care, raises questions about long term safety, resistance mechanisms, and cost-effectiveness, and calls for further research into biomarkers and treatment sequencing.

This editorial discusses the landmark EV 302 phase 3 trial comparing enfortumab vedotin plus pembrolizumab to platinum based chemotherapy in patients with untreated locally advanced or metastatic urothelial carcinoma. The combination therapy significantly improved progression-free survival (50.7% vs. 21.6% at 1 year) and overall survival (median 31.5 vs. 16.1 months), with a 67.7% response rate. Benefits were consistent across subgroups regardless of cisplatin eligibility or PD L1 status. The editorial highlights the shift in standard care, raises questions about long term safety, resistance mechanisms, and cost-effectiveness, and calls for further research into biomarkers and treatment sequencing.