Journal: Korean journal of radiology
This review focuses on the transformative impact of antibody-drug conjugates (ADCs), specifically enfortumab vedotin and trastuzumab deruxtecan, in treating advanced bladder cancer by targeting Nectin-4 and HER2.
These agents have significantly improved survival after chemotherapy and immunotherapy failure.
Imaging modalities such as CT, multiparametric MRI, and FDG-PET are essential for:
- Diagnosis and staging
- Monitoring treatment response
- Detecting recurrence
- Evaluating ADC-related toxicities like pneumonitis and gastrointestinal issues
Although response assessment primarily uses RECIST 1.1, multiparametric MRI is gaining attention for evaluating complete response in bladder lesions.
Challenges remain due to resistance mechanisms, prompting the need for next-generation ADCs.
The review emphasizes the importance of radiologists adapting to these evolving therapeutic approaches through a multidisciplinary effort to optimize patient outcomes.