Steroid Premedication Impact on Efficacy and Cutaneous Toxicity of Enfortumab Vedotin for Advanced Urothelial Carcinoma.

BACKGROUND/AIM: The impact of steroid premedication on the efficacy and cutaneous toxicity of enfortumab vedotin (EV) in advanced urothelial carcinoma (UC) is unclear.

PATIENTS AND METHODS

We retrospectively analyzed consecutive patients with advanced UC who received EV after the failure of platinum-based chemotherapy and immune checkpoint inhibitors from December 2021 to November 2024.

RESULTS

Twenty-eight patients (male, n=16; median age, 71 years) were enrolled. Dexamethasone 6.6 mg was administered intravenously prior to EV in six (21.4%) patients. There were no differences in the overall response and disease control rates between patients with and without steroid premedication (=0.653 and >0.99, respectively). The progression-free survival was not significantly associated with or without steroid premedication (not estimable 4.3 months, =0.501). There were no marked differences in the incidence of all grades of EV-related cutaneous adverse events (AEs) between patients with and without steroid premedication (33.3% 45.5%, =0.673). There was no significant difference in the incidence of grade ≥3 EV-related cutaneous AEs between the patients with and without steroid premedication (16.7% 36.4%, =0.630). Multivariate analysis revealed that a performance status ≥2 was an independent prognostic factor for progression-free survival (hazard ratio=4.653, 95% confidence interval=1.263-17.140, =0.021), and steroid premedication was not ( =0.869).

CONCLUSION

In EV treatment, steroid premedication did not affect clinical outcomes. The incidence and severity of EV-related cutaneous toxicity tended to improve in patients who received steroid premedication, although no significant differences were observed.