Smart Onc Studio

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  The Godfather of EV/Pembro: Dr. Jonathan Rosenberg on Bladder Cancer's Biggest Breakthrough 24.09.2026 32min

  In this episode of SmartOnc Studio, hosts Dr. Neil Shah and Dr. Matt Dallos sit down with Dr. Jonathan Rosenberg, Chief of the GU Medical Oncology Service at Memorial Sloan Kettering Cancer Center. He led the early-phase trials that brought enfortumab vedotin plus pembrolizumab (EV + Pembro) into practice, and this conversation covers how that regimen actually works, why it changed the standard of care, and what it takes to manage patients on it day to day.The first half of the episode walks through the science: how the antibody-drug conjugate targets nectin-4, and how the pivotal trials produced results strong enough to reshape treatment guidelines. The second half gets practical. Dr. Rosenberg breaks down the regimen's signature toxicities, including skin rash, hyperglycemia, peripheral neuropathy, and eye problems, and explains how he decides when to dose reduce, hold treatment, or push through.What You'll Discover in This Episode:01:16 — How enfortumab vedotin and pembrolizumab work together. The nectin-4 mechanism, the ADC design, and the early trials that led to approval05:24 — EV-302, the phase 3 trial that nearly doubled survival for metastatic urothelial cancer and reset the first-line standard of care07:32 — Moving into the perioperative setting. EV-303 and EV-304 (KEYNOTE-905) in muscle-invasive bladder cancer, and the ongoing debate over three cycles versus four12:55 — Managing toxicity. What skin rash, hyperglycemia, peripheral neuropathy, and eye side effects actually look like, and when each one tends to show up25:40 — Handling real-world situations like surgery, dental work, and radiation while a patient is on treatment, plus Dr. Rosenberg's top takeaways for cliniciansLet's ConnectSmart Onc StudioDr. Neil Shah Dr. Matt Dallos Dr. Jonathan Rosenberg