PADCEV 20 mg PADCEV contains Enfortumab Vedotin, an antibody-drug conjugate (ADC) composed of a human IgG1 monoclonal antibody targeting Nectin-4 attached via a protease-cleavable linker to the microtubule-disrupting agent monomethyl auristatin E (MMAE). Nectin-4 is an adhesion protein highly expressed on urothelial cancer cells. Upon binding to Nectin-4 on the cell surface, the ADC complex is internalized into the cell where MMAE is released via proteolytic cleavage, disrupting the intracellular microtubule network, inducing cell cycle arrest, and causing apoptotic cell death. It is indicated as monotherapy or in combination with pembrolizumab for the treatment of adult patients with locally advanced or metastatic urothelial cancer.