Sponsored Content: Optimising ▼Enfortumab Vedotin + Pembrolizumab in Comorbid Patients with Unresectable or Metastatic Urothelial Carcinoma

Aim: To provide practical recommendations to support the use of enfortumab vedotin combined with pembrolizumab (EV+P) for the first-line treatment of adult patients with unresectable or metastatic urothelial carcinoma (mUC) eligible for platinum-based chemotherapy who present with comorbid conditions. Method: An international advisory panel of experts was convened to provide input into the development of these recommendations. The panel reviewed representative clinical scenarios involving patients with mUC and discussed available evidence, as well as their clinical experience, to determine key practical considerations before and during EV+P administration. Results: Key recommendations for patients with peripheral neuropathy, skin toxicities, diabetes/hyperglycaemia, impaired renal function, frailty, obesity, and ocular disorders were presented. EV+P is the standard-of-care first-line treatment for patients with unresectable or mUC who are eligible for platinum-based chemotherapy, and patients who meet its approved indication (per the Summary of Product Characteristics) should be able to have access to it without unnecessary clinical restrictions. The expert panel considered that clinicians must familiarise themselves with its safety considerations and adverse event management strategies, especially in potentially challenging scenarios such as its use in patients with baseline comorbidities. Best practice was regarded as initiating EV+P at the recommended starting dose, with dose modifications as required. Conclusion: Clinical judgment and shared decision-making are key to help optimise EV+P treatment, especially in patients with complex clinical profiles.