Abstract

Abstract Antibody drug conjugates (ADCs) consist of an antibody, a cytotoxic payload, and a linker between the two. ADCs are becoming increasingly used in metastatic bladder cancer. Enfortumab vedotin (EV) in combination with pembrolizumab recently demonstrated impressive improvements in survival and overall responses compared to chemotherapy in the frontline metastatic setting. Sacituzumab govitecan (SG) and single agent EV are also effective, later line options for patients who have progressed on prior chemotherapy and/or immunotherapy. New ADCs, including those targeting HER2, have also displayed promising results in bladder cancer patients. Trials are exploring the use of ADCs in combination with each other as well as with immunotherapy. Novel ADCs with dual targets, dual payloads, and other augmentations are being developed and may represent new options for patients moving forward. However, these advances raise many questions. How to best manage the differing toxicities seen with ADCs? What is best sequencing of ADCs? What are the common resistance mechanisms to ADCs? How do these resistance mechanisms affect subsequent use of ADCs? And how effective are these agents in bladder cancer variants and divergent histologies? This talk with cover the expanding role of ADCs in metastatic bladder cancer. Citation Format: Nicholas Simon. Metastatic bladder cancer: The expanding role of antibody drug conjugates [abstract]. In: Proceedings of the AACR Special Conference on Bladder Cancer: Transforming the Field; 2024 May 17-20; Charlotte, NC. Philadelphia (PA): AACR; Clin Cancer Res 2024;30(10_Suppl):Abstract nr IA018.

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