Beyond managing hyperglycemia, GLP-1 inhibitors have been observed to improve neuropathy in diabetic patients receiving Enfortumab Vedotin (EV). This suggests a dual benefit, challenging the assumption that EV is the sole cause of worsening neuropathy in this population.
Continuous on-body glucose monitors provide granular, real-time data that is far more valuable than periodic A1C or fasting glucose tests. This allows for precise management of toxicities like hyperglycemia and neuropathy caused by drugs like Enfortumab Vedotin or AKT inhibitors.
To improve patient morale and adherence, clinicians can frame the development of a rash from enfortumab vedotin (EV) as a positive sign. Patients who develop this side effect are known to have better treatment responses, turning a negative experience into an encouraging one.
For patients who relapse on adjuvant nivolumab without prior immune-mediated toxicity, clinicians should consider treatment with enfortumab vedotin plus pembrolizumab. The synergy from EV's cell-killing mechanism may re-awaken the immune system, making the combination more effective than EV alone.
Clinicians should test all patients with upper tract urothelial cancer for Lynch syndrome, regardless of age. The condition is surprisingly prevalent in this rare cancer, and a diagnosis can fundamentally alter treatment by making patients prime candidates for highly effective immune checkpoint inhibitors.
When a patient on enfortumab vedotin (EV) develops a severe rash, clinicians must consider delayed toxicity from a prior checkpoint inhibitor (ICI). Immune effects like pemphigoid can manifest months after stopping an ICI, requiring different management and potentially precluding EV re-challenge.