Oncologists led by Thomas Powles at Barts Cancer Institute tested pairing two newer drugs, enfortumab vedotin and pembrolizumab, against the platinum chemotherapy that had been first-line treatment since the 1980s.
In a phase 3 trial of 886 patients with previously untreated advanced urothelial cancer, those given the drug pair lived a median of 31.5 months, compared with 16.1 months on chemotherapy. At three and a half years, 44 percent of the combination group were still alive versus about 25 percent on chemotherapy.
The trial, called EV-302, led regulators to approve the combination as a new first-line standard, replacing platinum chemotherapy for many patients for the first time in decades. More patients stopped treatment early because of side effects on the new combination than on chemotherapy, and researchers are now studying which patients benefit most and how to manage toxicity over longer courses of treatment.
Read the original study
Powles et al., New England Journal of Medicine, 2024 · doi.org/10.1056/NEJMoa2312117
Nearly double the survival, no chemo needed.
Source
- Powles, T., Valderrama, B. P., Gupta, S., Bedke, J., Kikuchi, E., Hoffman-Censits, J., Iyer, G., Vulsteke, C., Park, S. H., Shin, S. J., Castellano, D., Fornarini, G., Li, J.-R., Gümüş, M., Mar, N., Loriot, Y., Fléchon, A., Duran, I., Drakaki, A., . . . van der Heijden, M. S. (2024). Enfortumab Vedotin and Pembrolizumab in Untreated Advanced Urothelial Cancer. New England Journal of Medicine, 390(10), 875–888. https://doi.org/10.1056/NEJMoa2312117