Antibody-drug conjugates (ADCs) have powerful chemotherapy drugs attached to antibodies. They recognize tumors and deliver the chemotherapy right to them. ACDs have 3 parts:

• An antibody that binds to certain proteins or receptors on the surface of the cancer cell.
• A drug, such as chemotherapy, that can kill the cancer cell.
• A linker that connects the drug to the antibody. The linker keeps the drug bound to the antibody. It protects your body until the drug arrives at the cancer cell.

Together, these 3 parts deliver the drug to cancer cells, killing them while keeping healthy tissue safe.

MSK genitourinary oncologist Jonathan Rosenberg helped get approval from the U.S. Food and Drug Administration (FDA) for an ADC called enfortumab vedotin (Padcev). We use it to treat some people who have locally advanced or metastatic bladder cancer.

This ADC treatment is an option for people who either:

• Can’t have cisplatin chemotherapy, and their cancer is growing after 1 or more other treatments.
• Have cancer that is growing after treatment with immunotherapy and chemotherapy.

A new treatment shows good results for people with metastatic bladder cancer who have not yet had any treatment. Researchers tested a combination of the:

• Antibody-drug conjugate enfortumab vedotin (Padcev®)
• Checkpoint inhibitor pembrolizumab

We use another antibody-drug conjugate, sacituzumab govitecan (Trodelvy), to treat metastatic bladder cancer. It’s for people who already had platinum-based chemotherapy and a checkpoint inhibitor.