Enfortumab vedotin (EV) is a novel treatment option for patients with advanced/metastatic urothelial carcinoma who have progressed after chemotherapy and immunotherapy. Two patients at two different New England tertiary cancer care centers were treated with EV while concurrently receiving hemodialysis (HD), where a complete response to EV in both patients was noted. The use of EV in patients requiring HD is extrapolated from the available pharmacokinetic and pharmacodynamic literature on monoclonal antibodies in patients requiring HD. There is a paucity of data for the use of antibody-drug conjugates like EV in patients needing dialysis.
PowlesTRosenbergJESonpavdeGP, et al.Enfortumab-vedotin in previously treated advanced urothelial carcinoma. N Engl J Med2021; 384: 1125–1135.
2.
PowlesTBValderramaBPGuptaS, et al.LBA6 EV-302/KEYNOTE-A39: open-label, randomized phase III study of enfortumab vedotin in combination with pembrolizumab (EV + P) vs chemotherapy (Chemo) in previously untreated locally advanced metastatic urothelial carcinoma (la/mUC). Ann Oncol2023; 34: S1340.
3.
HatakeyamaSKoieTNaritaT, et al.Renal function outcomes and risk factors for stage 3B chronic kidney disease after urinary diversion in patients with muscle invasive bladder cancer. PLoS One2016; 11: e0149544.
4.
SgangaSRiondinoSIannantuonoGM, et al.Antibody–drug conjugates for the treatment of renal cancer: a scoping review on current evidence and clinical perspectives. J Pers Med2023; 13: 1339.
5.
Challita-EidPMSatpayevDYangP, et al.Enfortumab vedotin antibody–drug conjugate targeting nectin-4 is a highly potent therapeutic agent in multiple preclinical cancer models. Cancer Res2016; 76: 3003–3013.
6.
WaldmannTAStroberW. Metabolism of immunoglobulins. Prog Allergy [Internet]1969; 13: 1–110.
GonzálezAFGarciaPEGastaldoAS, et al.Safety and efficacy of trastuzumab emtansine (TDM-1) in a patient on hemodialysis for renal failure. Cancer Treat Res Commun2021; 27: 100314.
9.
ColletteKRMyintZWParasramkaSV,et al.Case report: safety and efficacy of enfortumab-vedotin in a patient with metastatic urothelial carcinoma undergoing peritoneal dialysis. Front Oncol2022; 12: 892793.
10.
IsodaBShigaMKandoriS, et al.Complete response to enfortumab vedotin in a hemodialysis patient with metastatic urothelial carcinoma: a case report. Case Rep Oncol2023; 16: 423–427.
11.
NanniL, et al.Successful employment of brentuximab-vedotin in a patient undergoing hemodialysis: the first real-life experience. Clinical Lymphoma, Myeloma and Leukemia2019; 19: e595–e596.
