Astellas and Seagen Announce Results on a Drug for Urothelial Cancer

According to a recent press release, Astellas and Seagen have teamed up to develop a combined treatment for urothelial cancer in patients who are ineligible to receive cisplatin chemotherapy. The new treatment plan consists of Padcev (enfortumab vedotin) and Keytruda (pembrolizumab). 

Based on information from the National Cancer Institute, a subset of the NIH, urothelial cancer is a “cancer that begins in cells called urothelial cells that line the urethra, bladder, ureters, renal pelvis, and some other organs.” 

A common type of urothelial cancer is bladder cancer. Data from the American Cancer Society approximates 81,180 new cases of bladder cancer in the United States alone. Furthermore, there have been an estimated 17,100 deaths from bladder cancer in the US this year. 

The standard treatment for bladder and other urothelial cancers is cisplatin chemotherapy. 

Cisplatin is defined by the National Cancer Institute as a chemical agent that “forms highly reactive, charged, platinum complexes, which bind to nucleophilic groups such as GC-rich sites in DNA, inducing intrastrand and interstrand DNA cross-links, as well as DNA-protein cross-links.” 

Although cisplatin is a highly effective chemotherapy widely used, it has limitations. A 2009 article from the Tohoku Journal of Experimental Medicine identified ototoxicity, nephrotoxicity, and neurotoxicity as potentially irreversible side effects of cisplatin. 

As a result, many pharmaceutical companies are looking for ways to reduce cisplatin’s side effects. 

“Approximately half of the patients with advanced urothelial carcinoma are ineligible for cisplatin-based chemotherapy,” said Ahsan Arozullah, MD, MPH, Senior Vice President and Head of Development Therapeutic Areas, Astellas, in the press release. 

In the clinical trial that explored enfortumab vedotin and pembrolizumab, there was a 64.5% objective response rate to the medication. Despite the efficacy and general safety of the medicines, there is a risk of side effects. 

Potential adverse reactions may include rash, anemia, urinary tract infection, hyperglycemia, fatigue, neutropenia, hematuria, diarrhea, acute kidney injury, hyponatremia, chronic kidney disease, weight loss, syncope, hypophosphatemia, pneumonitis, and sepsis. 

As further studies progress, oncologists may consider this medication regimen for patients unable to undergo standard treatments. However, additional research must be conducted on the long-term effects and efficacy of the medication. 

“We are encouraged by the positive topline results of Cohort K for the combination of enfortumab vedotin and pembrolizumab in first-line locally advanced or metastatic urothelial cancer, and we look forward to sharing results at an upcoming medical meeting,” said Roger Dansey, MD, interim CEO and Chief Medical Officer, Seagen, in the press announcement.