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Nectin-4 Antibody-Drug Conjugate

Enfortumab Vedotin

Brand names: Padcev

Enfortumab vedotin is a Nectin-4-directed antibody-drug conjugate used to treat locally advanced or metastatic urothelial (bladder) cancer, typically after prior therapy.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

Its antibody targets Nectin-4 on tumour cells and delivers the microtubule-disrupting agent monomethyl auristatin E intracellularly, causing cell-cycle arrest and apoptosis.

Prescribing in practice

  • It can cause serious and sometimes fatal skin reactions, including Stevens-Johnson syndrome and toxic epidermal necrolysis, so severe or blistering rashes require immediate discontinuation and specialist input.
  • Hyperglycaemia, including diabetic ketoacidosis, and peripheral neuropathy are important toxicities requiring monitoring.
  • Infusion-related reactions and ocular disorders may occur during treatment.

Monitoring

Monitor for skin reactions, blood glucose and peripheral neuropathy, and review ocular symptoms throughout treatment.

Counselling the patient

  • Report any new or worsening rash, blistering or peeling of the skin or mouth ulcers immediately.
  • Tell your team about increased thirst, excessive urination or numbness and tingling in your hands and feet.
  • Mention any changes in vision or dry, irritated eyes.

Evidence & guidelines

The EV-301 trial demonstrated that enfortumab vedotin improved overall survival compared with chemotherapy in previously treated advanced urothelial carcinoma.

Reference: EV-301 trial (Powles et al. NEJM 2021); EV-302 trial (NEJM 2024); NICE TA812; MHRA SPC Padcev; EAU Bladder Cancer Guidelines 2024; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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