EV-induced cutaneous adverse events signal good prognosis in advanced urothelial cancer

In patients with locally advanced or metastatic urothelial cancer, enfortumab vedotin (EV)-induced cutaneous adverse events (cAEs) are associated with improved survival outcomes, according to a retrospective study.

The study included 449 patients (mean age 71.9 years, 72.8 percent male) with locally advanced or metastatic urothelial cancer treated with EV. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan-Meier method.

Of the patients, 206 (45.9 percent) experienced cAEs. These events were severe in 39 patients (18.9 percent) and attributed to EV in 127 (61.7 percent). The most common cAEs were pruritus (41.3 percent), unspecified and desquamating dermatitis (37.3 percent), and morbilliform dermatitis (27.7 percent).

Survival was prolonged in patients with EV-induced cAEs. In multivariable time-varying and landmark Cox regression models, the presence of an EV-induced cAE was associated with significantly better PFS (hazard ratio [HR], 0.60, 95 percent confidence interval [CI], 0.43–0.82; p<0.001) and OS (HR, 0.46, 95 percent CI, 0.31–0.67; p<0.001) at 30 days (primary landmark).

Early-onset EV-induced cAEs were associated with favourable survival outcomes at all landmark times, and high-grade EV-induced cAEs were not associated with poor survival outcomes.

The findings indicate the potential of distinguishing EV-induced cAEs from other causes in timeline and morphologic mechanisms in guiding oncologic and dermatologic treatment and management.