Time-dependent indirect comparison of enfortumab vedotin plus pembrolizumab and disitamab vedotin plus toripalimab in advanced urothelial carcinoma

Enfortumab vedotin plus pembrolizumab (EV-P) and disitamab vedotin plus toripalimab (DV-T) improved first-line outcomes in the global phase III EV-302/KEYNOTE-A39 trial (all-comer population) and the Chinese phase III RC48-C016 trial (HER2-expressing tumours), respectively, but no head-to-head comparison is available. We reconstructed individual patient data from published overall survival (OS) and progression-free survival (PFS) Kaplan–Meier curves and performed time-dependent anchored indirect comparisons through the randomised platinum-gemcitabine control arms. Anchored PFS ratios of treatment hazard ratios (RHRs) were 1.41 (95% CI 0.86–2.30), 1.02 (0.63–1.66) and 0.62 (0.20–1.89) at 0–6, 6–12 and 12–18 months. Corresponding OS RHRs were 0.78 (0.36–1.66), 1.07 (0.61–1.88), 0.74 (0.34–1.62) and 0.48 (0.16–1.47) through 24 months. Continuous spline analyses suggested declining PFS RHRs over time, whereas OS showed no consistent pattern; all 95% CIs included 1. Population heterogeneity limits transitivity. These exploratory findings do not establish superiority, equivalence or interchangeability.