Targeting more than tumors: The impact of enfortumab vedotin and pembrolizumab (EV/P) on skeletal muscle loss and sarcopenia in metastatic urothelial carcinoma (mUC).

• DOI: 10.1200/jco.2025.43.5_suppl.689
• Publication Date: 2025-02-18T14:42:46Z
• Authors: Can Aydogdu; Simon Erwin Hahn; Isabel Brinkmann; Melanie Götz; Benazir Enzinger; Marie Semmler; Elena Berg; Frederik Kolligs; Alexander Tamalunas; Christian G. Stief; Jozefina Casuscelli
• Keywords: Metastatic Urothelial Carcinoma

689 Background: Sarcopenia and skeletal muscle loss are associated with poor prognosis limited survival in metastatic cancer patients. This study aims to assess the impact of systemic treatment enfortumab vedotin pembrolizumab (EV/P) on index (L3SMI) patients urothelial carcinoma (mUC). Methods: We conducted a retrospective analysis mUC treated EV/P at single German tertiary care center. L3SMI was measured baseline (before treatment) first radiographic staging, approximately three months post-treatment routinely obtained CT (computed tomography) or PET (positron emission imaging. L3 area using OsiriX software normalized by height squared calculate L3SMI. defined cutoffs based body mass (BMI): for men BMI <25 kg/m², <43 cm²/m²; ≥25 <53 women, regardless BMI, <41 cm²/m². Results: Between November 2023 October 2024, 24 (mUC) who had available imaging were included analysis. The median time between follow-up 84 days. At baseline, 46% met criteria sarcopenia, follow-up, 33% experienced significant (>4%), leading 50% being classified as sarcopenic. Despite this, not poorer staging outcomes. Of patients, 62.5% achieved partial response (PR), 25% stable disease (SD), 12.5% showed progressive (PD). Conversely, 16% gain during same period. A moderate, non-significant correlation found sarcopenia treatment-related adverse events (r=0.339, p=0.11 ). In contrast, observed onset therapy-induced peripheral neuropathy (r=0.418, p=0.042 Conclusions: emphasizes high prevalence real-world undergoing therapy, along notable within few treatment. Interestingly, this early decline did correlate Given that is continuous therapy inevitable development cumulative toxicities, monitoring may help implement strategies avoid them. Our findings suggest potential causal relationship loss, warranting further investigation. Larger studies extended needed deeper insight into long-term receiving