Abstract
INTRODUCTION: Enfortumab vedotin (EV), an antibody-drug conjugate targeting Nectin-4, has become a standard treatment option for metastatic urothelial carcinoma (mUC) following failure of platinum-based chemotherapy and immune checkpoint inhibitors. However, adverse events (AEs) such as skin toxicity often necessitate dose modification or temporary discontinuation. CASE PRESENTATION: We report the case of a 72-year-old woman with mUC who achieved a long-term partial response to EV despite experiencing grade 2 skin toxicity that required temporary treatment interruption. After symptom resolution, EV was successfully reintroduced at a reduced dose, and clinical response was maintained. CONCLUSION: Temporary discontinuation of EV due to AEs followed by intermittent reintroduction resulted in long-term disease control in this patient with mUC. This case suggests that rechallenging EV after treatment interruption may be a feasible approach in selected patients, underscoring the importance of careful AE management in real-world practice.