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Case Reports
. 2023 Oct;29(7):1789-1792.
doi: 10.1177/10781552231185505. Epub 2023 Jul 4.

Drug extravasation with Enfortumab vedotin

Christopher Ryan Grant  1 , Dimitri de Kouchkovsky  2 , Arash Rezazadeh Kalebasty  3 , Nataliya Mar  3
Affiliations
Case Reports

Drug extravasation with Enfortumab vedotin

Christopher Ryan Grant et al. J Oncol Pharm Pract. 2023 Oct.

Abstract

Introduction: Enfortumab vedotin is an antibody drug conjugate approved for management of pretreated locally advanced or metastatic urothelial carcinoma, which is associated with a rare risk of drug extravasation and soft tissue reactions.

Case report: We report two cases of EV extravasation with subsequent development of bullae and cellulitis.

Management and outcome: They were both treated for cellulitis and had conservative management without surgical intervention and were able to resume treatment with Enfortumab vedotin without subsequent adverse events.

Discussion: We propose that EV acts as a vesicant upon extravasation, highlight measures to prevent extravasation events, and encourage appropriate measures when dealing such as attempt of aspiration, removal of catheter, application of compresses, and thorough documentation with photographic evidence.

Keywords: Drug extravasation; Enfortumab vedotin; antibody drug conjugate; bladder cancer; irritant; vesicant.

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Conflict of interest statement

Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Case 1. Patient’s images of extravasation over time. 1a & 1b: 1 day after extravasation. Described as a smooth erythematous plaque with central areas of erosion and desquamation. 1c: 1 week after extravasation. Described as a scaly plaque with central erosion and fibrinous material. 1d: 2 weeks after extravasation. Described as a scaly patch with central hemorrhagic crusting in site of prior erosion.
Figure 2.
Figure 2.
Case 2. Patient’s image of extravasation after 6 days.
Figure 3.
Figure 3.
Timeline of management for extravasation events.
See this image and copyright information in PMC

References

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