OncLive® On Air S14 Ep36: Evolving Research Paradigms, Real-World Data, and Multidisciplinary Collaboration Enhance Bladder Cancer Management: With Amit Mehta, MD
Oct 29, 2025
Dr. Amit Mehta, a medical oncologist and urothelial carcinoma expert, shares insights on the latest advancements in bladder cancer treatment. He highlights the transformative FDA approval of enfortumab vedotin combined with pembrolizumab. Discussion includes how treatment strategies differ for patients with lymph node–only versus distant metastases, and the growing significance of biomarkers like Nectin‑4. Mehta emphasizes patient education, early detection of side effects, and the importance of a multidisciplinary approach in managing complications.
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New First-Line Standard Changed Practice
- Infortimab plus pembrolizumab became a preferred first-line option and shifted practice in 2024–2025.
- Multiple FDA approvals and guideline changes forced clinicians to refine patient selection rather than use one universal approach.
Metastatic Disease Is Heterogeneous
- Metastatic urothelial carcinoma shows marked heterogeneity, with lymph-node-only disease behaving differently than visceral or bone metastases.
- Patients with lymph-node-only metastases have much longer median survival in some trials, influencing therapy choice.
Biomarkers May Predict Enfortumab Benefit
- Biomarker enrichment (e.g., Nectin-4 amplification) may strongly predict response to enfortumab-based therapy.
- Early data showed Nectin-4–amplified tumors had dramatically lower risk of death with enfortumab plus pembrolizumab.