Learn The BasicsTargeted therapies are cancer treatments designed to attack specific changes in cancer cells that help them grow and survive, while causing less damage to normal cells.
Two important targeted therapies for the treatment of bladder cancer are erdafitinib and enfortumab vedotin.
Erdafitinib
Erdafitinib, sold under the brand name Balvera, is used to treat bladder cancer that has spread to other parts of the body and that cannot be removed with surgery in patients who have tried at least one chemotherapy drug that did not work. The treatment is usually not given to patients who have not yet received an immune checkpoint inhibitor.
Erdafitinib is suitable for patients who have a mutation in their fibroblast growth factor receptor 3 (FGFR3) gene. This gene contains the information necessary to make a protein that is involved in the growth and spread of cancer cells. Erdafitinib works by blocking the action of this protein, thereby inhibiting the growth of cancer cells.
Erdafitinib is given as once-daily oral tablets.
The side effects of erdafitinib include dry mouth, mouth sores, loss of appetite, diarrhea, fatigue, changes in kidney or liver function, fingernails or toenails, mineral levels in the blood and taste, anemia, dry skin and eyes and hair loss.
Other side effects may include redness, swelling, peeling, or tenderness on the hands or feet, known as hand-foot syndrome, abdominal pain, nausea, constipation and muscle pain.
Erdafitinib may also cause eye problems that can sometimes be serious, like blurred vision, other visual changes and even vision loss. Thus, patients taking erdafitinib should have regular eye exams during treatment.
Enfortumab vedotin
Enfortumab vedotin is an antibody-drug conjugate– a treatment that uses an antibody to deliver chemotherapy drugs directly to cancer cells..
Enfortumab vedotin, sold under the brand name Padcev, is an antibody-drug conjugate that is used to treat patients with bladder cancer. The antibody portion of the medicine attaches to a protein called Nectin-4, found on the surface of bladder cancer cells.
It can be used together with the cancer immunotherapy drug pembrolizumab in patients with muscle-invasive bladder cancer or bladder cancer that has spread to the muscle wall of the bladder.
It can also be used on its own to treat patients with advanced bladder cancer who have already received a platinum-based chemotherapy drug like cisplatin and an immune checkpoint inhibitor, or patients who cannot be treated with cisplatin and who have already received at least one type of drug treatment.
Enfortumab vedotin is given as an intravenous infusion once a week for 2 to 3 weeks, followed by a week off.
Common side effects of enfortumab vedotin include fatigue, numbness or tingling in the hands or feet, nausea, reduced appetite, diarrhea, taste changes, rash, hair loss, dry eyes and skin, itching and high levels of blood sugar.
More serious side effects include skin reactions, lung inflammation and very high levels of blood sugar.