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Biologic

Enfortumab vedotin

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Overview

Enfortumab vedotin, sold under the brand name Padcev, is an antibody-drug conjugate used for the treatment of urothelial cancer. It is a nectin-4-directed antibody and microtubule inhibitor conjugate. Enfortumab refers to the monoclonal antibody part, and vedotin refers to the payload drug (MMAE) and the linker.[1–4] WP

The most common side effects include fatigue, peripheral neuropathy (nerve damage resulting in tingling or numbness), decreased appetite, rash, alopecia (hair loss), nausea, altered taste, diarrhea, dry eye, pruritus (itching) and dry skin.[3] WP

The fully humanized antibody was created by scientists at Agensys (part of Astellas) using Xenomice from Amgen; the linker technology holding the antibody and the toxin together was provided by and licensed from Seattle Genetics.[5] WP

The U.S. Food and Drug Administration (FDA) considers it to be a first-in-class medication.[6] WP

Uses, dosage and effects

Medical uses

Enfortumab vedotin is indicated for the treatment of adults with locally advanced (when cancer has grown too large to be surgically removed) or metastatic (when cancer cells spread to other parts of the body) urothelial cancer who have previously received a programmed death receptor-1 (PD-1) or programmed death ligand 1 (PD-L1) inhibitor and a platinum-containing chemotherapy.[2][3][4] WP

History

History

Results of a Phase I clinical trial were reported in 2016.[1] WP

In December 2019, enfortumab vedotin was approved in the United States for the treatment of adult patients with locally advanced or metastatic urothelial cancer who had previously received a programmed cell death receptor-1 (PD-1) or programmed death ligand 1 (PD-L1) inhibitor and a platinum-containing chemotherapy. The approval was based on the results of a clinical trial of 125 such patients. The overall response rate, reflecting the percentage of patients who had a certain amount of tumor shrinkage, was 44%; specifically, 12% had a complete response and 32% a partial response. The median duration of response was 7.6 months.[3][7] WP

The U.S. Food and Drug Administration (FDA) granted the application for enfortumab vedotin accelerated approval, priority review designation, and breakthrough therapy designation. The FDA granted the approval of Padcev to Astellas Pharma US Inc.[3] WP

In July 2021, the FDA approved enfortumab vedotin for adults with locally advanced or metastatic urothelial cancer who have previously received a PD-1 or PD-L1 inhibitor and platinum-containing chemotherapy, or who are ineligible for cisplatin-containing chemotherapy and have previously received therapy.[8] WP

Chemistry

Awaiting sourceFormula, structure and identifiers from PubChem.

Harm reduction information

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Sources

  1. Other Seattle Genetics and Agensys, an Affiliate of Astellas, Highlight Promising Enfortumab Vedotin (ASG-22ME) and ASG-15ME Phase 1 Data in Metastatic Urothelial Cancer at 2016 ESMO Congress. 7 October 2016
  2. Journal / agency Padcev ejfv- enfortumab vedotin injection, powder, lyophilized, for solution
  3. Journal / agency FDA approves new type of therapy to treat advanced urothelial cancer. 18 December 2019
  4. Journal / agency Padcev EPAR. 14 September 2021
  5. Journal / agency Challita-Eid PM, Satpayev D, Yang P, An Z, Morrison K, Shostak Y, Raitano A, Nadell R, Liu W, Lortie DR, Capo L, Verlinsky A, Leavitt M, Malik F, Aviña H, Guevara CI, Dinh N, Karki S, Anand BS, Pereira DS, Joseph IB, Doñate F, Morrison K, Stover DR. Enfortumab Vedotin Antibody-Drug Conjugate Targeting Nectin-4 Is a Highly Potent Therapeutic Agent in Multiple Preclinical Cancer Models. Cancer Research. May 2016. doi:10.1158/0008-5472.can-15-1313 · PMID 27013195
  6. Journal / agency New Drug Therapy Approvals 2019. 31 December 2019
  7. Journal / agency Drug Trials Snapshots: Padcev. 13 December 2019
  8. Journal / agency FDA grants regular approval to enfortumab vedotin-ejfv for locally advanced or metastatic urothelial cancer. 9 July 2021
  9. Journal / agency Padcev: Pending EC decision. 16 December 2021
  10. Other Padcev Product information
  11. Journal / agency International nonproprietary names for pharmaceutical substances (INN): recommended INN: list 71. WHO Drug Information. 2014
  12. Other Statement On A Nonproprietary Name Adopted By The USAN Council - Enfortumab Vedotin, American Medical Association. link 2

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