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ESMO Immuno-Oncology 2025 | The emerging role of ADC and checkpoint inhibitor combinations in UC

Laurence Buisseret, MD, PhD, Institute Jules Bordet, Brussels, Belgium, discusses the emerging role of antibody drug conjugate (ADC) and immune checkpoint inhibitor (ICI) combinations in solid tumors, highlighting recent approvals and ongoing trials in urothelial carcinoma (UC). The combination of enfortumab vedotin and pembrolizumab has shown promising results in both advanced and neoadjuvant settings for urothelial carcinoma, and is now a new standard of care for first-line treatment of locally advanced metastatic disease. This interview took place at 2025 European Society for Medical Oncology (ESMO) Immuno-Oncology Congress in London, UK.

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Transcript

So yes, at ESMO, there was a special session within the industry on antibody drug conjugate, RD immunotherapies, and my talk focused on ADC and ICI combination in a solid tumor. So there are a lot of trials ongoing, already some results that are known specifically in advanced urothelial carcinoma with Enfortumab Vedotin, and Pembrolizumab, which is now approved in this indication since December 2023...

So yes, at ESMO, there was a special session within the industry on antibody drug conjugate, RD immunotherapies, and my talk focused on ADC and ICI combination in a solid tumor. So there are a lot of trials ongoing, already some results that are known specifically in advanced urothelial carcinoma with Enfortumab Vedotin, and Pembrolizumab, which is now approved in this indication since December 2023. So the first-line treatment for patients with locally advanced metastatic urothelial carcinoma, regardless of cisplatin eligibility. So this is really a new standard of care, and it is the first ADC and ICI combination. There was also another approval in China with a Chinese ADC. So the combination in urothelial carcinoma is moving now in the neoadjuvant setting. At ESMO, a few weeks ago, we had the presentation of the result of the EV303. So it is neoadjuvant, and Enfortumab Vedotin, and Pembrolizumab, this time in the neoadjuvant setting for patients with cisplatin-eligible muscle-invasive bladder carcinoma. And it demonstrated, but it was compared to observation, that this neoadjuvant treatment with ADC and Pembrolizumab increased the pCR rate, event-free survival and overall survival. There is a trial ongoing that compared this neoadjuvant regimen to chemotherapy for patients with cisplatin-eligible muscle-invasive bladder carcinoma. Then I move to breast cancer. In breast cancer, there is also a lot of ADC and ICI combination that are under evaluation.

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