Enfortumab vedotin plus pembrolizumab is a very effective regimen in the treatment of advanced urothelial carcinoma but is difficult to tolerate. We discuss the rationale for establishing patient selection criteria for this combination, taking into consideration the potential for life-altering side effects, limited real-world experience with the regimen among oncologists, patient preferences in balancing treatment effectiveness against toxicity, and the precedent in establishing eligibility criteria for platinum-based chemotherapy.
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