A Nectin-4 antibody-drug conjugate for bladder and urinary-tract cancer
Enfortumab vedotin
A targeted treatment given by drip for advanced cancer of the bladder and urinary tract.
What is Enfortumab vedotin?
Enfortumab vedotin is a specialist targeted treatment for advanced cancer of the bladder and urinary tract (urothelial cancer). It is an antibody-drug conjugate, which means an antibody seeks out a marker called Nectin-4 on cancer cells and delivers a chemotherapy payload directly to them. It is given as a drip into a vein in cycles. Its most important risks are serious skin reactions, including rare but life-threatening blistering rashes such as Stevens-Johnson syndrome, raised blood sugar (hyperglycaemia), nerve damage in the hands and feet, and eye problems, so it is closely monitored.
Education and reference only. This is a plain-language guide to Enfortumab vedotin — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Enfortumab vedotin is a targeted cancer medicine used to treat advanced or spread cancer of the bladder and urinary tract, known as urothelial cancer. It is an antibody-drug conjugate: an antibody that homes in on a marker called Nectin-4, which is found on these cancer cells, joined to a chemotherapy drug. This lets it carry the chemotherapy more directly to the cancer. It is given as an infusion into a vein in repeated cycles by a specialist cancer team, who monitor for its particular side effects, especially skin reactions.
How it works
Many bladder and urinary-tract cancer cells carry a marker on their surface called Nectin-4. The antibody part of enfortumab vedotin attaches to this marker, and the whole package is then taken inside the cancer cell, where the attached chemotherapy is released to damage the cell and stop it growing. By using the antibody as a guide, more of the chemotherapy is delivered to the cancer. However, some healthy tissues also carry the marker or are affected by the released drug, which explains side effects such as skin reactions, nerve problems and raised blood sugar.
Company & origin
Originated / developed by: Specialist manufacturer.
A specialist targeted treatment used in the UK for advanced cancer of the bladder and urinary tract (urothelial cancer).
Practical use
How to take Enfortumab vedotin
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Have it as a drip into a vein on the schedule your specialist cancer team arranges, attending all appointments.
- Report any new or spreading rash, blisters, peeling skin or sores in the mouth or eyes straight away, as serious skin reactions can occur.
- Tell your team if you feel very thirsty, pass a lot of urine, or feel drowsy or confused, as blood sugar can rise.
- Report tingling, numbness or weakness in the hands or feet, and any eye dryness or vision changes.
- Use reliable contraception during treatment and for the time afterwards that your team advises, and report any possible pregnancy promptly.
Weighing it up
Advantages & disadvantages of Enfortumab vedotin
Advantages
- A targeted treatment that delivers chemotherapy more directly to bladder and urinary-tract cancer cells.
- An effective option for advanced urothelial cancer, including after other treatments.
- Given in repeated cycles as a drip under specialist care.
Disadvantages
- Can cause serious skin reactions, including rare but life-threatening blistering rashes.
- Can raise blood sugar, sometimes seriously, even in people without diabetes.
- Can damage the nerves in the hands and feet, affect the eyes, and harm an unborn baby.
Practical use
Good to know
The most important safety point with enfortumab vedotin is skin reactions, which can range from a mild rash to rare but life-threatening blistering and peeling reactions such as Stevens-Johnson syndrome and toxic epidermal necrolysis. Any spreading rash, blisters, peeling skin, or sores in the mouth, eyes or genitals must be reported urgently, as treatment may need to be stopped. It can also raise blood sugar, sometimes seriously, even in people without diabetes, so symptoms such as feeling very thirsty, passing a lot of urine, or feeling confused must be reported. Over time it can damage the nerves in the hands and feet, causing tingling, numbness or weakness, and it can cause dry or irritated eyes. Because it is a chemotherapy-based treatment that can harm an unborn baby, reliable contraception is important during treatment and for a time afterwards.
Who should not take it / use with caution
- People who have had a serious allergic reaction to enfortumab vedotin should not have it.
- It is not used in pregnancy or while breastfeeding, as it can harm an unborn baby.
- It is used with particular care in people with diabetes, existing nerve problems or eye conditions, under specialist judgement.
Monitoring
- Regular skin checks for rashes and serious blistering reactions throughout treatment.
- Blood sugar checks, especially in people with or at risk of diabetes.
- Watching for nerve symptoms in the hands and feet and for eye dryness or vision changes.
Side effects
- Skin reactions, from rash and itching to rare but serious blistering and peeling reactions needing urgent care.
- Raised blood sugar, sometimes serious, with thirst, passing a lot of urine or confusion.
- Tingling, numbness or weakness in the hands and feet from nerve damage.
- Dry or irritated eyes, tiredness, hair loss, reduced appetite and infusion reactions.
Key interactions
- Other medicines that can affect blood sugar may need review, especially if you have diabetes.
- Medicines that can affect the nerves may add to nerve side effects, so tell your team.
- Tell your team about all your medicines, including anything bought over the counter, before and during treatment.
Available as: A powder made up into a solution for infusion into a vein.
Answers
Enfortumab vedotin: frequently asked questions
What is enfortumab vedotin used for?
It is a targeted treatment for advanced cancer of the bladder and urinary tract, delivering chemotherapy directly to cancer cells that carry a marker called Nectin-4.
Why are skin reactions so important?
It can cause serious, rarely life-threatening blistering skin reactions, so any spreading rash, blisters, peeling skin or sores in the mouth or eyes must be reported urgently.
Can it affect my blood sugar?
Yes, it can raise blood sugar even in people without diabetes, so report symptoms such as feeling very thirsty, passing a lot of urine, or feeling confused.
Will it affect my hands and feet?
It can damage the nerves over time, causing tingling, numbness or weakness in the hands and feet, which you should report so treatment can be adjusted.
Do I need contraception?
Yes. Because it can harm an unborn baby, reliable contraception is important during treatment and for a time afterwards, as your team advises.
Authoritative sources
- BNF
- NICE CKS
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