• Amanda Pace, Blaine Brower, Dawn Conway, and Dayna Leis.
• Dana-Farber Cancer Institute.
• Clin J Oncol Nurs. 2021 Apr 1; 25 (2): E1-E9.

BackgroundMany patients with locally advanced or metastatic urothelial carcinoma (mUC) need additional treatment options beyond PD-1 or PD-L1 inhibitors and platinum-based chemotherapies. Enfortumab vedotin-ejfv (EV) is an antibody-drug conjugate directed at Nectin-4 that received accelerated approval for treatment of adults with locally advanced or mUC previously treated with PD-1/PD-L1 inhibitors and platinum- containing chemotherapy in the neoadjuvant/adjuvant, locally advanced, or metastatic settings.ObjectivesThis article provides practical considerations and recommendations regarding common and potentially treatment-limiting adverse events that may arise with EV therapy.MethodsThe clinical data that supported the approval of EV are reviewed, and supporting safety and management considerations are provided based on the authors' experience.FindingsEV therapy can be optimized through patient and caregiver education, proactive patient monitoring, early identification of adverse events, and timely intervention to alleviate symptoms.

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