TOPLINE

Enfortumab vedotin (EV)-induced cutaneous adverse events were tied to improved survival in patients with advanced urothelial cancer in a study.

METHODOLOGY

• Researchers conducted a retrospective cohort study of 449 patients (mean age, 71.9 years; 72.8% men; 91% White) with advanced urothelial cancer treated with EV between 2020 and 2025.
• Patients received either EV alone (n = 172), EV plus pembrolizumab (EV + ICI; n = 256), or EV plus sacituzumab govitecan, ALX148 (anti-CD47), or GEN-009 vaccine (EV + other; n = 21).
• Cutaneous adverse events (cAEs) were attributed to EV or other causes using a likelihood score from 0 to 4; scores of 3 or 4 were classified as EV-induced.
• Main outcomes included progression-free survival (PFS) and overall survival (OS) at 30 days.

TAKEAWAY

• Of the 206 patients who developed cAEs, 127 (61.7%) were linked to EV; the most common cAEs were pruritus (41.3%), unspecified and desquamating dermatitis (37.3%), and morbilliform dermatitis (27.7%).
• Median PFS and median OS were 5.2 months and 10.9 months, respectively, in the EV alone group; and 10.6 months and 21.0 months, respectively, in the EV + ICI group.
• EV-induced cAEs were tied to improved PFS (hazard ratio [HR], 0.60; P < .001) and OS (HR, 0.46; P < .001) at 30 days. The association was significant after adjustments for factors like treatment group.
• Early-onset EV-induced cAEs within 15 days of treatment initiation were tied to greater PFS (HR, 0.57; P = .002) and OS (HR, 0.42; P < .001), but late-onset cAEs showed no significant association.

IN PRACTICE

“EV-induced cAEs were independently associated with improved survival outcomes, suggesting that cAEs may serve as an early biomarker of therapeutic effectiveness among patients treated with EV, and that the distinct temporal characteristics of cAEs may help clinicians with treatment decision-making,” the study authors wrote.

SOURCE

This study was led by Eudora Lee and Ralina Karagenova, MS, Harvard Medical School, Boston, and was published online on July 29, 2026, in JAMA Dermatology.

LIMITATIONS

This study was retrospective and may have had residual confounding. Attribution of cAEs to EV was based on health record reviews and subject to observer bias. Additionally, clinical descriptions, photographs, and histologic data were not always available.

DISCLOSURES

The authors did not disclose any funding sources. Two authors disclosed receiving grants from the National Institutes of Health during the conduct of the study. Several authors reported receiving grants, consulting fees, equity, and patents, as well as having ties to various sources including Bristol Myers Squibb, Pyxis Oncology, Nanometics, and others. Full disclosures are noted in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.