ESMO 2025 | Subgroup findings from the EV-302 trial of EV and pembrolizumab in la/mUC
Michiel Van der Heijden, MD, PhD, Netherlands Cancer Institute, Amsterdam, Netherlands, explores subgroup findings from the Phase III EV-302 trial (NCT04223856) of enfortumab vedotin plus pembrolizumab versus chemotherapy in previously untreated locally advanced or metastatic urothelial cancer (la/mUC). Consistent improvements in overall and progression-free survival across prespecified groups, including patients stratified by cisplatin eligibility, liver involvement, visceral disease, or lymph node–only metastases were reported. The findings support EV plus pembrolizumab as a standard first-line option in this setting. This interview took place at the European Society for Medical Oncology (ESMO) 2025 Congress in Berlin, Germany.
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Transcript
Yeah, so the EV-302 trial was a trial that compared EV, so enfortumab vedotin plus pembrolizumab against chemotherapy, which was the standard of care and showed a large benefit for the new treatment, EV plus pembrolizumab. So in the past, the treatment of metastatic bladder cancer has been dominated by platinum eligibility. Can a patient receive cisplatin? Can a patient receive carboplatin? But I think all of this is now a thing of the past...
Yeah, so the EV-302 trial was a trial that compared EV, so enfortumab vedotin plus pembrolizumab against chemotherapy, which was the standard of care and showed a large benefit for the new treatment, EV plus pembrolizumab. So in the past, the treatment of metastatic bladder cancer has been dominated by platinum eligibility. Can a patient receive cisplatin? Can a patient receive carboplatin? But I think all of this is now a thing of the past. So if we look in any subgroup that was traditionally important, for example, platinum eligibility, but also the presence of liver metastasis, lymph node only, in all of these groups, we saw a very consistent benefit of EV plus pembrolizumab over chemotherapy. So I think the conclusions are that whatever way you slice it, EV plus pembrolizumab in all patients who are eligible to receive it should be the first option in the advanced setting.
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