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Antibody Drug Conjugates in Bladder Cancer: Current Milestones and Future Perspectives

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Opinion Statement

Over the last several years, the treatment landscape of urothelial carcinoma has witnessed an unprecedented expansion of therapeutic options including checkpoint inhibitors, tyrosine kinase inhibitors, and antibody drug conjugates (ADC). Early trial data has shown that ADCs are safer and potentially effective treatment options in advanced bladder cancer as well as in the early disease. In particular, enfortumab–vedotin (EV) has shown promising results with a recent cohort of a clinical trial demonstrating that EV is effective as neoadjuvant monotherapy as well as in combination with pembrolizumab in metastatic setting. Similar promising results have been shown by other classes of ADC in other trials including sacituzumab–govitecan (SG) and oportuzumab monatox (OM). ADCs are likely to become a mainstay treatment option in the urothelial carcinoma playbook as either a monotherapy or combination therapy. The cost of the drug presents a real challenge, but further trial data may justify the use of the drug as mainstay treatment.

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Authors and Affiliations

  1. Division of Hematology Oncology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA

    Raafat Alameddine MD & Yousef Zakharia MD

  2. Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, USA

    Patrick Mallea MD

  3. Department of Emergency Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, USA

    Farhan Shahab MD

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Grant/research support from institution clinical trial support from NewLink Genetics, Pfizer, Exelixis, and Eisai.

DSMC: Janssen Research and Development

Consultant honorarium: Pfizer, Novartis

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Raafat Alameddine, Patrick Mallea, and Farhan Shahab declare that they have no conflicts of interest. Yousef Zakharia has disclosed the following: Advisory Board: Bristol Myers Squibb, Amgen, Roche Diagnostics, Novartis, Janssen, Eisai, Exelixis, Castle Bioscience, Genzyme Corporation, Astrazeneca, Array, Bayer, Pfizer, Clovis, EMD serono, and Myovant.

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Alameddine, R., Mallea, P., Shahab, F. et al. Antibody Drug Conjugates in Bladder Cancer: Current Milestones and Future Perspectives. Curr. Treat. Options in Oncol. 24, 1167–1182 (2023). https://doi.org/10.1007/s11864-023-01114-y

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