Association of Prophylactic Intravenous Corticosteroid Premedication With Toxicity and Survival in Patients Receiving Enfortumab Vedotin for Locally Advanced or Metastatic Urothelial Carcinoma - PubMe
5 hours ago
- #enfortumab vedotin
- #corticosteroid premedication
- #urothelial carcinoma
- Prophylactic intravenous corticosteroid premedication (dexamethasone 6.6 mg) was evaluated in patients receiving enfortumab vedotin (EV) for locally advanced or metastatic urothelial carcinoma (la/mUC).
- The study involved 157 patients, with 20 receiving steroid premedication and 137 not receiving it.
- Steroid premedication significantly reduced the incidence of skin adverse events (AEs) (10% vs. 62.7%, p < 0.001) and cumulative AEs (median 1 vs. 2, p = 0.018).
- Objective response rates (ORR) were comparable between the two groups.
- Patients with steroid premedication showed inferior overall survival (OS) (median OS 10.3 vs. 17.4 months, p = 0.008), while progression-free survival (PFS) showed no significant difference.
- Multivariable analysis confirmed steroid premedication as an independent predictor of reduced skin AEs (OR 0.08, p = 0.001) but was associated with worse OS (HR 1.91, p = 0.048).
- Inverse probability of treatment weighting (IPTW)-adjusted analysis confirmed the association of steroid premedication with worse OS.
- The study concludes that while corticosteroid premedication reduces skin toxicities, its impact on survival outcomes remains uncertain and requires further validation in larger studies.