From the Research
Enfortumab vedotin does not necessarily require a central line for administration, and it can be administered through a peripheral IV line. The decision to use a central line versus peripheral access should be made based on the patient's vascular access status, expected duration of therapy, and institutional protocols 1. When using a peripheral line, care should be taken to ensure proper venous access as extravasation can cause tissue damage. Patients with poor peripheral venous access, those requiring multiple IV medications, or those on long-term treatment might benefit from a central line. Enfortumab vedotin is an antibody-drug conjugate that targets Nectin-4, a protein expressed in urothelial cancers, and delivers a microtubule-disrupting agent to cancer cells, which explains why proper administration is important to maximize efficacy while minimizing adverse effects 2. The medication is typically given as an intravenous infusion over 30 minutes at a recommended dose of 1.25 mg/kg (up to a maximum of 125 mg) on days 1,8, and 15 of a 28-day cycle. Real-world studies have demonstrated the efficacy and safety of enfortumab vedotin in patients with metastatic urothelial cancer, with acceptable treatment-related adverse events 3. It is essential to monitor patients for adverse events, including skin reactions, and to manage them promptly to minimize their impact on the patient's quality of life 4. Institutional protocols and patient-specific factors should guide the decision on the use of central lines for enfortumab vedotin administration, prioritizing the patient's safety and comfort. Overall, the administration of enfortumab vedotin through a peripheral IV line is feasible and effective, but the decision should be individualized based on the patient's needs and circumstances 5.