Furubayashi Nobuki, Mochida Manabu, Kijima Atsuhiro, Fujimoto Yushi, Nakamura Motonobu, Negishi Takahito
Department of Urology, NHO Kyushu Cancer Center, Fukuoka, Japan
Department of Urology, NHO Kyushu Cancer Center, Fukuoka, Japan.
Anticancer Res. 2025 May;45(5):2185-2193. doi: 10.21873/anticanres.17592.
BACKGROUND/AIM: Enfortumab vedotin (EV) has been approved for the treatment of advanced urothelial carcinoma (UC) following platinum-based chemotherapy and immune checkpoint inhibitors (ICIs). However, there is no established treatment for patients whose disease progresses while on EV, and the clinical outcomes post-EV treatment are unclear.
From December 2021 to January 2025, 33 patients with advanced UC received EV monotherapy. After excluding those who discontinued EV due to adverse events or continued treatment without progression, 18 patients were retrospectively analyzed.
The median follow-up was 4.1 months, and 16 patients (88.9%) died at the last follow-up. Ten patients received post-EV treatment (five received chemotherapy and five received ICIs), and eight opted for best supportive care (BSC). The overall survival (OS) was not significantly different between the post-EV and BSC groups (4.6 3.7 months, =0.425). No significant differences in the progression-free survival (2.5 3.2 months, =0.945) or OS (2.6 5.1 months, =0.832) were observed between chemotherapy and ICI treatment in the post-EV treatment group. Patients with lymph node-only metastases had significantly longer OS than those with other metastases (13.5 3.3 months, =0.039) in the post-EV treatment group.
Post-EV treatment did not significantly improve the survival compared with BSC in patients with advanced UC. However, patients with lymph node-only metastases may show better outcomes than others. Further research is required to identify effective treatment strategies for this population.
背景/目的：恩沃利单抗（EV）已被批准用于铂类化疗和免疫检查点抑制剂（ICI）治疗后的晚期尿路上皮癌（UC）。然而，对于在接受EV治疗期间疾病进展的患者，尚无既定的治疗方法，且EV治疗后的临床结局尚不清楚。
2021年12月至2025年1月，33例晚期UC患者接受了EV单药治疗。排除因不良事件停用EV或持续治疗无进展的患者后，对18例患者进行回顾性分析。
中位随访时间为4.1个月，16例患者（88.9%）在最后一次随访时死亡。10例患者接受了EV后治疗（5例接受化疗，5例接受ICI），8例选择了最佳支持治疗（BSC）。EV后治疗组和BSC组的总生存期（OS）无显著差异（4.6对3.7个月，P = 0.425）。EV后治疗组中，化疗和ICI治疗之间的无进展生存期（2.5对3.2个月，P = 0.945）或OS（2.6对5.1个月，P = 0.832）无显著差异。在EV后治疗组中，仅发生淋巴结转移的患者的OS显著长于有其他转移的患者（13.5对3.3个月，P = 0.039）。
对于晚期UC患者，与BSC相比，EV后治疗并未显著提高生存率。然而，仅发生淋巴结转移的患者可能比其他患者有更好的结局。需要进一步研究以确定针对该人群的有效治疗策略。
