IJU case reports · 2026
Conversion to Pathological Complete Response by Enfortumab Vedotin in Metastatic Sarcomatoid Urothelial Carcinoma With Nectin-4 Expression: A Case Report.
СтатьяНазвание и аннотация: Перевод в очереди
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Chon Sonin, Nagamoto Shoichi, Yamashita Takahisa, Fujii Kenta, Yokota Kazuki, Tachibana Kojiro, Kitayama Sachi, Okada Yohei, Kawakami Satoru, Yano Akihiro
Аннотация
INTRODUCTION: Sarcomatoid urothelial carcinoma (UC) is an extremely rare and aggressive subtype with a poor prognosis. Reports on the efficacy of enfortumab vedotin (EV) in this subtype remain limited.
CASE PRESENTATION: A 74-year-old man presented with gross hematuria and was diagnosed with metastatic sarcomatoid UC of the urinary bladder with Nectin-4 expression. First-line chemotherapy with gemcitabine plus carboplatin therapy was initiated; however, lymph node metastases progressed. After second-line pembrolizumab therapy, new pulmonary and para-aortic lymph node metastases developed. Third-line EV therapy achieved a partial response in the bladder cancer and complete response in metastatic lesions. The patient subsequently underwent robot-assisted radical cystectomy with ileal conduit diversion, and pathological examination revealed no residual carcinoma (ypT0N0). He has remained disease-free for 30 months without additional therapy.
CONCLUSION: EV may induce substantial and clinically meaningful responses in selected patients with metastatic sarcomatoid UC expressing Nectin-4, even after failure of platinum-based chemotherapy and immune checkpoint inhibition.
CASE PRESENTATION: A 74-year-old man presented with gross hematuria and was diagnosed with metastatic sarcomatoid UC of the urinary bladder with Nectin-4 expression. First-line chemotherapy with gemcitabine plus carboplatin therapy was initiated; however, lymph node metastases progressed. After second-line pembrolizumab therapy, new pulmonary and para-aortic lymph node metastases developed. Third-line EV therapy achieved a partial response in the bladder cancer and complete response in metastatic lesions. The patient subsequently underwent robot-assisted radical cystectomy with ileal conduit diversion, and pathological examination revealed no residual carcinoma (ypT0N0). He has remained disease-free for 30 months without additional therapy.
CONCLUSION: EV may induce substantial and clinically meaningful responses in selected patients with metastatic sarcomatoid UC expressing Nectin-4, even after failure of platinum-based chemotherapy and immune checkpoint inhibition.