Podcast: Enfortumab Vedotin and the Evolving Landscape of Bladder Cancer Care: A Pharmacist’s Guide to ADCs, Combination Therapy, and Expanding Clinical Engagement

Over the course of this video series, Kristen Nymberg, PharmD, BCOP; and Emma Jones, PharmD, BCOP, provide a comprehensive overview of the rapidly evolving bladder cancer treatment landscape, with a particular focus on the expanding role of enfortumab vedotin (EV) and the increasing involvement of pharmacists in patient care. As systemic therapies and combination regimens continue to move into earlier disease settings, particularly for muscle-invasive bladder cancer (MIBC) and advanced urothelial carcinoma, pharmacists are becoming essential members of multidisciplinary oncology teams. The speakers emphasize that pharmacists now play a far more active role than in years past, contributing not only to supportive care but also to treatment selection, sequencing, toxicity monitoring, patient counseling, and coordination across oncology settings. At the same time, the series highlights persistent undertreatment in bladder cancer and explores how pharmacists can help identify eligible patients earlier, address barriers to care, and support evidence-based treatment access.

A major focus throughout the discussion is the growing clinical importance of EV and antibody-drug conjugates (ADCs) in bladder cancer management. Nymberg and Jones explain EV’s unique mechanism of action, review pivotal evidence supporting EV-based regimens such as EV plus pembrolizumab, and discuss how emerging clinical data are reshaping treatment paradigms beyond traditionally cisplatin-ineligible populations. Across multiple episodes, the speakers examine practical considerations surrounding EV implementation, including patient eligibility, toxicity recognition, adverse event management, and adherence challenges. Common toxicities—including peripheral neuropathy, dermatologic reactions, ocular toxicities, and hyperglycemia—are discussed in depth, with particular attention given to proactive monitoring strategies and pharmacist-driven patient education. The series repeatedly reinforces that early symptom recognition, individualized counseling, and timely multidisciplinary communication are essential to minimizing treatment interruptions and improving patient outcomes.

The conversation concludes with a strong emphasis on the operational and clinical realities of integrating EV into oncology practice and preparing pharmacists for the future of bladder cancer care. Nymberg and Jones discuss barriers such as prior authorization delays, referral coordination, infusion workflow demands, and treatment-related adherence challenges, and highlight strategies that have improved implementation across community and health system settings. Looking ahead, they underscore the need for expanded pharmacist training in ADC management, greater involvement in multidisciplinary tumor boards, and stronger disease-specific education resources as bladder cancer therapies continue to evolve. Ultimately, the series positions pharmacists as indispensable clinical partners whose proactive involvement in patient identification, toxicity management, adherence support, and care coordination can meaningfully improve outcomes for patients with bladder cancer.