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Tumor Discovery

CASE REPORT
Complete response after two cycles of

enfortumab vedotin in a patient with metastatic
bladder cancer: A case report

Ali Kaan Güren* , Murat Sari , and Osman Köstek

Department of Internal Medicine, Division of Medical Oncology, Marmara University School of
Medicine, Istanbul, Turkey

Abstract

Metastatic urothelial carcinoma, the most common subtype of advanced bladder
cancer, remains associated with poor outcomes and limited treatment options
despite systemic therapies. Enfortumab vedotin (EV), an antibody-drug conjugate
targeting Nectin-4, has shown significant improvements in progression-free
and overall survival in platinum- and immunotherapy-pretreated patients, as
demonstrated in the EV-201 and EV-301 trials. In this report, we present a case of
a patient who had previously received platinum-based neoadjuvant chemotherapy
and experienced disease progression under nivolumab maintenance therapy but
subsequently achieved a complete response in a short period with EV treatment. EV
has emerged as a valuable treatment alternative in this aggressive disease, where
survival expectations are generally poor. However, questions remain regarding which
*Corresponding author: patients benefit most from the treatment and whether the response is correlated
Ali Kaan Güren with nectin-4 expression levels.
(ali.guren@marmara.edu.tr)
Citation: Güren AK, Sari M,
Köstek O. Complete response after Keywords: Metastatic urothelial carcinoma; Enfortumab vedotin; Complete response
two cycles of enfortumab vedotin
in a patient with metastatic bladder
cancer: A case report. Tumor
Discov. 2025;4(3):92-95.
doi: 10.36922/TD025150026 1. Background
Received: April 07, 2024 Non-muscle invasive bladder cancer accounts for approximately 75% of all bladder
cancer cases, while muscle-invasive bladder cancer (MIBC) accounts for the remaining
Revised: May 19, 2025
25%. Although the rate of metastatic disease is around 5% at the time of diagnosis, distant
Accepted: May 22, 2025 metastases can develop in up to 50% of patients during follow-up despite receiving
Published online: June 5, 2025 radical treatments, especially in patients diagnosed with MIBC. 1
Copyright: © 2025 Author(s). Metastatic urothelial carcinoma (mUC) is the most common histological subtype
This is an Open-Access article of advanced bladder cancer. Despite systemic treatment approaches, mUC remains
2
distributed under the terms of the
Creative Commons Attribution associated with poor survival outcomes and limited therapeutic options. Platinum-based
License, permitting distribution, chemotherapy protocols have long been accepted as the standard approach for the first-
and reproduction in any medium, line treatment of metastatic disease; however, many patients develop non-response or
provided the original work is
properly cited. relapse. While the use of immunotherapy in mUC has expanded in recent years, effective
targeted therapies are still lacking for those who develop resistance or do not derive
Publisher’s Note: AccScience
Publishing remains neutral with sufficient clinical benefit from these agents. 3,4
regard to jurisdictional claims in
published maps and institutional Enfortumab vedotin (EV) is an antibody-drug conjugate targeting Nectin-4, a protein
affiliations. highly expressed in urothelial carcinoma cells. Upon binding to nectin-4 on the tumor

Volume 4 Issue 3 (2025) 92 doi: 10.36922/TD025150026