Clinical and direct immunofluorescence characteristics of cutaneous toxicity associated with enfortumab vedotin.

Penny, Caitlin L; Quow, Krystina; Rundle, Chandler W; Al-Rohil, Rami N; Cardones, Adela R; Kheterpal, Meenal K; Fresco, Amber I · Br J Dermatol · 2022

case_report · Level V

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Abstract

Enfortumab vedotin (EV), a novel antibody-drug conjugate approved for metastatic urothelial carcinoma, causes a variety of cutaneous adverse reactions. We present two cases of bullous eruptions following treatment with EV, both demonstrating IgG deposition on direct immunofluorescence (DIF) correlating to the location of nectin-4 in the epidermis. This suggests that the IgG component of EV binding to nectin-4 in keratinocytes is likely a primary contributor to the high rates of cutaneous toxicity.

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