A new study confirms that enfortumab vedotin plus pembrolizumab (EV/P) works just as well in the real world as it did in clinical trials for metastatic bladder cancer. Compared to standard chemo, EV/P nearly doubled median overall survival (20 vs. 11 months) and cut the risk of needing next-line therapy in half. The findings hold up even in patients with more complex health profiles.
EV + pembrolizumab delivers real-world results for metastatic bladder cancer
A large retrospective study published in JAMA Network Open confirms that enfortumab vedotin plus pembrolizumab (EV/P) translates its clinical trial success into routine practice. Analyzing over 4,400 adults with metastatic urothelial carcinoma from the TriNetX database, researchers found that EV/P significantly outperformed gemcitabine plus cisplatin (G/C) across multiple outcomes — even in patients with higher comorbidity burdens.
These findings are further reinforced by updated data from the EV-302/KEYNOTE-A39 trial (presented at ASCO 2026), which showed a median OS of 33.6 months with EV/P vs. 15.9 months with chemotherapy at a median follow-up of ~3.5 years — with researchers suggesting some patients may actually be cured.
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Why it matters: These results validate EV/P as the go-to first-line standard of care for metastatic urothelial carcinoma in everyday clinical settings — not just in tightly controlled trials. For oncologists treating patients with complex comorbidities, the data offer reassurance that the survival benefits are real, durable, and broadly applicable.
