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Cavitation of Pulmonary Metastases During Enfortumab Vedotin for Metastatic Ureteral Urothelial Carcinoma

Year: 2025

Type: article

Abstract: Introduction: Enfortumab vedotin (EV), a Nectin-4-targeted antibody-drug conjugate, is active in previously treated urothelial carcinoma. Cavitation of pulmonary metastases is classically linked to squamous histology or anti-angiogenic/cytotoxic regimens; rarely reported under EV. Case Presentation: A 69-year-old woman with upper-tract urothelial carcinoma developed pulmonary and hepatic metastases. During EV, multiple lung nodules rapidly cavitated into thin-walled lesions while liver disease shrank. No infectious symptoms; overall survival was 12 months from EV start. Discussion: Cavitation likely reflects treatment-related necrosis once infection and EV-related pneumonitis are excluded. Diameter-based criteria can misjudge response when solid nodules cavitate; short-interval re-imaging is advisable. Pulmonary response may not ensure systemic control. Conclusion: Recognizing EV-associated cavitation as a response pattern may prevent premature discontinuation of effective therapy and unnecessary antibiotics.

Source: IJU Case Reports

DOI: 10.1002/iju5.70120

Authors: Fumihiro Ito, Koki Kobayashi, Gaku Hayashi, Shunsuke Kamijo, Takashi Fujita

Institution: Gifu Prefectural Tajimi Hospital

Language: English

Topic: Bladder and Urothelial Cancer Treatments

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $4,960