Incorporating KEYNOTE-905 Into Clinical Practice

In this segment, experts focus on translating KEYNOTE-905’s findings into real-world application. Determining whether a patient should receive pembrolizumab alone or in combination with enfortumab vedotin depends on factors such as performance status, comorbidities, and tumor aggressiveness. Patient fitness and tolerance remain key, as the combination regimen, while potentially more effective, may carry increased toxicity risk. A tailored approach that balances efficacy and safety is therefore essential.

Managing treatment sequencing after perioperative therapy is also discussed. For patients who later develop recurrence or metastasis, prior exposure to immunotherapy requires thoughtful planning for subsequent lines of treatment. Clinical teams must coordinate surveillance, assess biomarkers, and consider re-challenging with immunotherapy or introducing targeted agents based on evolving disease profiles.

Adherence and toxicity management are practical challenges highlighted by clinicians. To ensure completion of both neoadjuvant and adjuvant phases, patient engagement, proactive symptom control, and streamlined communication are vital. Multidisciplinary care teams—nurses, pharmacists, and oncologists—must monitor side effects closely and intervene early. Through structured follow-up and patient education, healthcare providers can optimize tolerance, minimize interruptions, and ensure the full therapeutic benefit of perioperative immunotherapy is realized.