Racial differences in cutaneous events among patients receiving enfortumab vedotin

Micro-Abstract This retrospective study compared the frequency of enfortumab vedotin (EV) - related cutaneous events (EVCEs) between Black and White patients in 2 real-world cohorts. EVCEs were more common among Black patients who had received prior pembrolizumab, suggesting that further study of these events in this population, frequently under-represented in oncology trials, is warranted. Introduction Enfortumab vedotin (EV) is an antibody–drug conjugate approved alone and in combination with pembrolizumab for advanced urothelial cancer (UC). EV-related-cutaneous-events (EVCEs) are common and rarely life-threatening. Black patients are frequently under-represented in oncology trials, and dermatologic conditions may vary with race. Methods Therefore, this retrospective analysis investigated differences in EVCE frequency between Black and White patients in an urban cohort (Johns Hopkins [JH]) and a US-based, nationwide electronic health record (EHR)-derived de-identified database with sub-group analysis of those who had received prior pembrolizumab. Results The study included 12 Black patients in the JH Cohort (17.1%) and 24 Black patients in the FH Cohort (7.6%). In both cohorts, the frequency of EVCEs among Black patients was higher compared to White patients (JH: 66.7% vs. 33.3%; FH: 25.0% vs. 15.8%), though not statistically significant. In the larger FH Cohort EVCEs were significantly more common among Black compared to White patients treated with prior pembrolizumab (Odds Ratio [OR]: 4.76 [95% CI: 1.42, 15.95]) and recent pembrolizumab (within 90 days of EV initiation) (OR 9.00 [95% CI: 1.94, 41.66]). Conclusion This hypothesis-generating retrospective study, comprising the largest population of EV-treated Black patients reported to date, emphasizes the importance of attentiveness to EVCEs among Black patients, particularly with receipt of pembrolizumab.