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**Enfortumab vedotin + pembrolizumab** is a combination therapy consisting of enfortumab vedotin, an antibody-drug conjugate targeting Nectin-4, and pembrolizumab, a monoclonal antibody immune checkpoint inhibitor targeting PD-1. The combination irreversibly disrupts tumor cells expressing Nectin-4 via the microtubule-disrupting cytotoxin MMAE (delivered by enfortumab vedotin), triggering immunogenic cell death, while pembrolizumab blocks the interaction between PD-1 and PD-L1, releasing the inhibition of T-cell–mediated antitumor immunity. This combined approach leads to increased tumor antigen presentation and sustained immune-mediated tumoral cytotoxicity. It is approved for first-line treatment of adults with locally advanced or metastatic urothelial carcinoma and demonstrates improved progression-free and overall survival compared to platinum-based chemotherapy[1][3][4][5][7][9].
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