How close are we to getting a vaccine for Lyme disease?
Or, it's possible the good fortune is due to what some are hoping is a "game changer" in the fight against the disease, which is caused by tick-borne bacteria and, if left untreated, can lead to severe heart, joint and nervous system symptoms.
Moser is one of dozens of people in Nova Scotia, and more than 9,000 in the eastern United States, Eastern Canada and parts of Europe, who are taking part in clinical trials for a vaccine against Lyme infection.
"I think it's incredibly important to have," she said of a vaccine, noting she knows at least four people who have contracted Lyme disease, including one who has had it multiple times.
"It's such a tricky disease, like when you get Lyme, so many things can happen. It causes joint pain, it causes inflammation. It really affects your system in a deep and abiding way."
There were more than 27,000 cases of Lyme disease recorded in Canada between 2009 and 2024, the majority of those in the last four years. Actual infection rates are higher, however, because cases go undetected or unreported, according to the federal government.
In the United States, over 89,000 cases were reported in 2023 to the Centers for Disease Control. In one study, researchers used insurance claims data to estimate that nearly half a million people a year may be diagnosed and treated for Lyme disease.
The vaccine furthest along the research pipeline is the collaboration between multinational pharmaceutical giant Pfizer and European vaccine company Valneva SE, with Phase 3 clinical trials scheduled to run to the end of December.
WATCH | How close are we to getting a vaccine for Lyme disease?:
A Pfizer spokesperson said if trials are successful the company could potentially apply in 2026 to the U.S. Food and Drug Administration and the European Medicines Agency for approvals to market the vaccine. There is no timeline for a similar application to Health Canada.
The clinical trials have targeted areas where Lyme disease is endemic. Participants were chosen for their increased risk, including landscapers in tick-infested areas, people who do a lot of hiking or gardening, or who have dogs that routinely come home with ticks attached.
Like all participants, Moser doesn't know if she has been injected with a course of the real vaccine and a booster, or simply been given a placebo, although she hopes to learn which it is once the trials end.
Some, but not all, blacklegged ticks carry Borrelia burgdorferi, the bacteria that causes Lyme disease. The ticks are tiny, living in woods, shrubs and long grass, attaching themselves to humans or animals that brush past the vegetation and then feeding on their blood.
When they bite, some of their stomach contents, including the bacteria, are eventually discharged into the bloodstream. In most cases, the tick must be attached for at least 24 hours before a person is infected.
The Pfizer-Valneva vaccine prompts the human body to create antibodies to a protein on Borrelia burgdorferi, according to Dr. Joanne Langley, a pediatrician with the Canadian Center for Vaccinology, a Halifax-based group helping conduct the clinical trials in Nova Scotia.
Ideally, if a Borrelia burgdorferi-carrying tick latches on to the skin, the vaccinated immune system will recognize the bacteria and attack and clear it, preventing Lyme disease, Langley said.
"It could be really a game changer for how we try to deal with Lyme infection," she said in an interview, adding that half of people who contract the disease don't even remember being bitten by a tick.
"It would be really great if we could be a little more carefree in the woods and just walking around our environment."
Found widely in the eastern United States, the first colony of blacklegged ticks in Canada was discovered in the 1970s in an Ontario provincial park on Lake Erie.
It has since become established in six provinces. In Nova Scotia, which has some of the highest tick numbers, populations are growing both in rural and urban areas, according to the provincial government.
What has perplexed some people who ritually pick ticks off their pets or who have been infected with Lyme is why it has taken so long to develop a vaccine, especially given Lyme vaccines for dogs have been available for years.
A Lyme vaccine for humans did hit the market in 1998, but was pulled in 2002 by the company that developed it, citing poor sales. Its reputation had been damaged by reports of adverse reactions, even though the FDA didn't find any evidence it was causing harm.
Thomas Hart, a microbiologist who studies Lyme disease at Johns Hopkins Bloomberg School of Public Health in Baltimore, said the controversy "just chilled the whole field."
"That's part of why we're only now seeing momentum again and bringing the Lyme disease vaccine actually through clinical trials in to market," he said.
Hart has not been involved with the Pfizer-Valneva work, but said it's a "real promising vaccine" and it will be a "big deal" if approved.
But it's not the only vaccine research. For instance, Hart said, scientists are examining vaccines aimed at deterring ticks from simply feeding on humans, protecting people not just against Lyme disease, but from other tick-borne infections.
Another strain of research attacks the problem from an imaginative angle — small food-like pellets coated in vaccine to inoculate, of all things, mice. It's an idea conceived by Dr. Maria Gomes-Solecki, a veterinarian and microbiologist at the University of Tennessee Health Science Center.
Mice and ticks, she said, infect each other with Borrelia burgdorferi. Vaccinating mice attempts to break the cycle. That brings down the prevalence in an area of ticks that have the bacteria, which in turn cuts the risk of humans getting Lyme disease.
"One strategy alone is not enough to control this disease," she said in an interview.
The company US Biologic has been marketing the product for about a year and a half, according to president Chris Przybyszewski. Pellets can tossed using a scoop — at intervals at the sides of trails, for instance — or deployed near homes in small circular "stations."
The product is aimed at homeowners, golf courses, summer camps, outdoor athletic facilities and pest-management outfits. The company is also working with governments to deploy it on public lands, he said.
The pellets, shaped like acorns, don't provide any nutritional value and don't attract other animals, Przybyszewski said. But the mice will eat them, he said, and research shows they can cut the rate of infected ticks in an area by 75 per cent.
There are plans to eventually bring the product to Canada, he said, with US Biologic likely to begin seeking approval this year or next.
"I think it's just incredibly important that we pay more attention to this kind of concept, really focusing on products and programs that can make a difference and really create a new way of stopping infectious diseases," he said.
For Colin Chase, a participant in the Pfizer-Valneva vaccine clinical trials, ticks are a fact of life, both as someone with a deep love of the woods, and as a volunteer search and rescuer who routinely clambers through dense Nova Scotia forests.
Searchers take the full range of precautions, he said, examining each other for the tiny creatures, stripping down before they go inside their homes and throwing their clothes in the dryer and then the washer. Many have a favoured anti-tick spray they swear by.
But even with those efforts, ticks can still sneak in and become embedded on the skin. If a vaccine is safe and effective, Chase said, why wouldn't someone take advantage?
"Because otherwise the alternative is, 'Oh, I'm not going to go in the woods. I'm going to disconnect myself from the natural environment.' And there's so much beauty in the woods," he said.
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PADCEV is also approved as a single agent for the treatment of adult patients with la/mUC who have previously received a PD-1/PD-L1 inhibitor and platinum-containing chemotherapy or are ineligible for cisplatin-containing chemotherapy and have previously received one or more prior lines of PADCEV® (enfortumab vedotin-ejfv) U.S. Indication & Important Safety Information BOXED WARNING: SERIOUS SKIN REACTIONS PADCEV can cause severe and fatal cutaneous adverse reactions including Stevens-Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN), which occurred predominantly during the first cycle of treatment, but may occur later. Closely monitor patients for skin reactions. Immediately withhold PADCEV and consider referral for specialized care for suspected SJS or TEN or severe skin reactions. Permanently discontinue PADCEV in patients with confirmed SJS or TEN; or Grade 4 or recurrent Grade 3 skin reactions. IndicationPADCEV®, in combination with pembrolizumab, is indicated for the treatment of adult patients with locally advanced or metastatic urothelial cancer (mUC).PADCEV, as a single agent, is indicated for the treatment of adult patients with locally advanced or mUC who: have previously received a programmed death receptor-1 (PD-1) or programmed death-ligand 1 (PD-L1) inhibitor and platinum-containing chemotherapy, or are ineligible for cisplatin-containing chemotherapy and have previously received one or more prior lines of therapy. PADCEV Important Safety Information Warnings and Precautions Skin reactions Severe cutaneous adverse reactions, including fatal cases of SJS or TEN occurred in patients treated with PADCEV. SJS and TEN occurred predominantly during the first cycle of treatment but may occur later. Skin reactions occurred in 70% (all grades) of the 564 patients treated with PADCEV in combination with pembrolizumab in clinical trials. 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Grade 3-4 skin reactions occurred in 14% of patients, including maculo-papular rash, erythematous rash, rash or drug eruption, symmetrical drug-related intertriginous and flexural exanthema (SDRIFE), bullous dermatitis, exfoliative dermatitis, and palmar-plantar erythrodysesthesia. The median time to onset of severe skin reactions was 0.6 months (range: 0.1 to 8 months). Among patients experiencing a skin reaction leading to dose interruption who then restarted PADCEV (n=75), 24% of patients restarting at the same dose and 24% of patients restarting at a reduced dose experienced recurrent severe skin reactions. Skin reactions led to discontinuation of PADCEV in 3.1% of patients. Monitor patients closely throughout treatment for skin reactions. Consider topical corticosteroids and antihistamines, as clinically indicated. For persistent or recurrent Grade 2 skin reactions, consider withholding PADCEV until Grade ≤1. Withhold PADCEV and refer for specialized care for suspected SJS, TEN or for Grade 3 skin reactions. Permanently discontinue PADCEV in patients with confirmed SJS or TEN; or Grade 4 or recurrent Grade 3 skin reactions. Hyperglycemia and diabetic ketoacidosis (DKA), including fatal events, occurred in patients with and without pre-existing diabetes mellitus, treated with PADCEV. Patients with baseline hemoglobin A1C ≥8% were excluded from clinical trials. In clinical trials of PADCEV as a single agent, 17% of the 720 patients treated with PADCEV developed hyperglycemia of any grade; 7% of patients developed Grade 3-4 hyperglycemia (Grade 3: 6.5%, Grade 4: 0.6%). Fatal events of hyperglycemia and DKA occurred in one patient each (0.1%). The incidence of Grade 3-4 hyperglycemia increased consistently in patients with higher body mass index and in patients with higher baseline A1C. The median time to onset of hyperglycemia was 0.5 months (range: 0 to 20 months). 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The incidence of pneumonitis/ILD, including severe events, occurred at a higher rate when PADCEV was given in combination with pembrolizumab compared to PADCEV as a single agent. The median time to onset of any grade pneumonitis/ILD was 4 months (range: 0.3 to 26 months). In clinical trials of PADCEV as a single agent, 3% of the 720 patients treated with PADCEV had pneumonitis/ILD of any grade and 0.8% had Grade 3-4. The median time to onset of any grade pneumonitis/ILD was 2.9 months (range: 0.6 to 6 months). Monitor patients for signs and symptoms indicative of pneumonitis/ILD such as hypoxia, cough, dyspnea or interstitial infiltrates on radiologic exams. Evaluate and exclude infectious, neoplastic and other causes for such signs and symptoms through appropriate investigations. Withhold PADCEV for patients who develop Grade 2 pneumonitis/ILD and consider dose reduction. Permanently discontinue PADCEV in all patients with Grade 3 or 4 pneumonitis/ILD. 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Monitor patients for symptoms of new or worsening PN and consider dose interruption or dose reduction of PADCEV when PN occurs. Permanently discontinue PADCEV in patients who develop Grade ≥3 PN. Ocular disorders were reported in 40% of the 384 patients treated with PADCEV as a single agent in clinical trials in which ophthalmologic exams were scheduled. The majority of these events involved the cornea and included events associated with dry eye such as keratitis, blurred vision, increased lacrimation, conjunctivitis, limbal stem cell deficiency, and keratopathy. Dry eye symptoms occurred in 30% of patients, and blurred vision occurred in 10% of patients, during treatment with PADCEV. The median time to onset to symptomatic ocular disorder was 1.7 months (range: 0 to 30.6 months). Monitor patients for ocular disorders. Consider artificial tears for prophylaxis of dry eyes and ophthalmologic evaluation if ocular symptoms occur or do not resolve. Consider treatment with ophthalmic topical steroids, if indicated after an ophthalmic exam. Consider dose interruption or dose reduction of PADCEV for symptomatic ocular disorders. Infusion site extravasation Skin and soft tissue reactions secondary to extravasation have been observed after administration of PADCEV. Of the 720 patients treated with PADCEV as a single agent in clinical trials, 1% of patients experienced skin and soft tissue reactions, including 0.3% who experienced Grade 3-4 reactions. Reactions may be delayed. Erythema, swelling, increased temperature, and pain worsened until 2-7 days after extravasation and resolved within 1-4 weeks of peak. Two patients (0.3%) developed extravasation reactions with secondary cellulitis, bullae, or exfoliation. Ensure adequate venous access prior to starting PADCEV and monitor for possible extravasation during administration. If extravasation occurs, stop the infusion and monitor for adverse reactions. Embryo-fetal toxicity PADCEV can cause fetal harm when administered to a pregnant woman. Advise patients of the potential risk to the fetus. Advise female patients of reproductive potential to use effective contraception during PADCEV treatment and for 2 months after the last dose. Advise male patients with female partners of reproductive potential to use effective contraception during treatment with PADCEV and for 4 months after the last dose. ADVERSE REACTIONS Most common adverse reactions, including laboratory abnormalities (≥20%) (PADCEV in combination with pembrolizumab)Increased aspartate aminotransferase (AST), increased creatinine, rash, increased glucose, PN, increased lipase, decreased lymphocytes, increased alanine aminotransferase (ALT), decreased hemoglobin, fatigue, decreased sodium, decreased phosphate, decreased albumin, pruritus, diarrhea, alopecia, decreased weight, decreased appetite, increased urate, decreased neutrophils, decreased potassium, dry eye, nausea, constipation, increased potassium, dysgeusia, urinary tract infection and decreased platelets. Most common adverse reactions, including laboratory abnormalities (≥20%) (PADCEV monotherapy)Increased glucose, increased AST, decreased lymphocytes, increased creatinine, rash, fatigue, PN, decreased albumin, decreased hemoglobin, alopecia, decreased appetite, decreased neutrophils, decreased sodium, increased ALT, decreased phosphate, diarrhea, nausea, pruritus, increased urate, dry eye, dysgeusia, constipation, increased lipase, decreased weight, decreased platelets, abdominal pain, dry skin. EV-302 Study: 440 patients with previously untreated la/mUC (PADCEV in combination with pembrolizumab)Serious adverse reactions occurred in 50% of patients treated with PADCEV in combination with pembrolizumab. The most common serious adverse reactions (≥2%) were rash (6%), acute kidney injury (5%), pneumonitis/ILD (4.5%), urinary tract infection (3.6%), diarrhea (3.2%), pneumonia (2.3%), pyrexia (2%), and hyperglycemia (2%). Fatal adverse reactions occurred in 3.9% of patients treated with PADCEV in combination with pembrolizumab including acute respiratory failure (0.7%), pneumonia (0.5%), and pneumonitis/ILD (0.2%). Adverse reactions leading to discontinuation of PADCEV occurred in 35% of patients. The most common adverse reactions (≥2%) leading to discontinuation of PADCEV were PN (15%), rash (4.1%) and pneumonitis/ILD (2.3%). Adverse reactions leading to dose interruption of PADCEV occurred in 73% of patients. The most common adverse reactions (≥2%) leading to dose interruption of PADCEV were PN (22%), rash (16%), COVID‑19 (10%), diarrhea (5%), pneumonitis/ILD (4.8%), fatigue (3.9%), hyperglycemia (3.6%), increased ALT (3%) and pruritus (2.5%). Adverse reactions leading to dose reduction of PADCEV occurred in 42% of patients. The most common adverse reactions (≥2%) leading to dose reduction of PADCEV were rash (16%), PN (13%) and fatigue (2.7%). EV-103 Study: 121 patients with previously untreated la/mUC who were not eligible for cisplatin-containing chemotherapy (PADCEV in combination with pembrolizumab)Serious adverse reactions occurred in 50% of patients treated with PADCEV in combination with pembrolizumab; the most common (≥2%) were acute kidney injury (7%), urinary tract infection (7%), urosepsis (5%), sepsis (3.3%), pneumonia (3.3%), hematuria (3.3%), pneumonitis/ILD (3.3%), urinary retention (2.5%), diarrhea (2.5%), myasthenia gravis (2.5%), myositis (2.5%), anemia (2.5%), and hypotension (2.5%). Fatal adverse reactions occurred in 5% of patients treated with PADCEV in combination with pembrolizumab, including sepsis (1.6%), bullous dermatitis (0.8%), myasthenia gravis (0.8%), and pneumonitis/ILD (0.8%). Adverse reactions leading to discontinuation of PADCEV occurred in 36% of patients; the most common (≥2%) were PN (20%) and rash (6%). Adverse reactions leading to dose interruption of PADCEV occurred in 69% of patients; the most common (≥2%) were PN (18%), rash (12%), increased lipase (6%), pneumonitis/ILD (6%), diarrhea (4.1%), acute kidney injury (3.3%), increased ALT (3.3%), fatigue (3.3%), neutropenia (3.3%), urinary tract infection (3.3%), increased amylase (2.5%), anemia (2.5%), COVID‑19 (2.5%), hyperglycemia (2.5%), and hypotension (2.5%). Adverse reactions leading to dose reduction of PADCEV occurred in 45% of patients; the most common (≥2%) were PN (17%), rash (12%), fatigue (5%), neutropenia (5%), and diarrhea (4.1%). EV-301 Study: 296 patients previously treated with a PD-1/L1 inhibitor and platinum-based chemotherapy (PADCEV monotherapy)Serious adverse reactions occurred in 47% of patients treated with PADCEV; the most common (≥2%) were urinary tract infection, acute kidney injury (7% each), and pneumonia (5%). Fatal adverse reactions occurred in 3% of patients, including multiorgan dysfunction (1%), hepatic dysfunction, septic shock, hyperglycemia, pneumonitis/ILD, and pelvic abscess (0.3% each). Adverse reactions leading to discontinuation occurred in 17% of patients; the most common (≥2%) were PN (5%) and rash (4%). Adverse reactions leading to dose interruption occurred in 61% of patients; the most common (≥4%) were PN (23%), rash (11%), and fatigue (9%). Adverse reactions leading to dose reduction occurred in 34% of patients; the most common (≥2%) were PN (10%), rash (8%), decreased appetite, and fatigue (3% each). EV-201, Cohort 2 Study: 89 patients previously treated with a PD-1/L1 inhibitor and not eligible for cisplatin-based chemotherapy (PADCEV monotherapy)Serious adverse reactions occurred in 39% of patients treated with PADCEV; the most common (≥3%) were pneumonia, sepsis, and diarrhea (5% each). Fatal adverse reactions occurred in 8% of patients, including acute kidney injury (2.2%), metabolic acidosis, sepsis, multiorgan dysfunction, pneumonia, and pneumonitis/ILD (1.1% each). Adverse reactions leading to discontinuation occurred in 20% of patients; the most common (≥2%) was PN (7%). Adverse reactions leading to dose interruption occurred in 60% of patients; the most common (≥3%) were PN (19%), rash (9%), fatigue (8%), diarrhea (5%), increased AST, and hyperglycemia (3% each). Adverse reactions leading to dose reduction occurred in 49% of patients; the most common (≥3%) were PN (19%), rash (11%), and fatigue (7%). DRUG INTERACTIONSEffects of other drugs on PADCEV (Dual P-gp and Strong CYP3A4 Inhibitors)Concomitant use with dual P-gp and strong CYP3A4 inhibitors may increase unconjugated monomethyl auristatin E exposure, which may increase the incidence or severity of PADCEV toxicities. Closely monitor patients for signs of toxicity when PADCEV is given concomitantly with dual P-gp and strong CYP3A4 inhibitors. SPECIFIC POPULATIONSLactation Advise lactating women not to breastfeed during treatment with PADCEV and for 3 weeks after the last dose. Hepatic impairment Avoid the use of PADCEV in patients with moderate or severe hepatic impairment. For more information, please see the U.S. full Prescribing Information including BOXED WARNING for PADCEV here. About AstellasAstellas is a global life sciences company committed to turning innovative science into VALUE for patients. We provide transformative therapies in disease areas that include oncology, ophthalmology, urology, immunology and women's health. Through our research and development programs, we are pioneering new healthcare solutions for diseases with high unmet medical need. Learn more at About Pfizer OncologyAt Pfizer Oncology, we are at the forefront of a new era in cancer care. Our industry-leading portfolio and extensive pipeline includes three core mechanisms of action to attack cancer from multiple angles, including small molecules, antibody-drug conjugates (ADCs), and bispecific antibodies, including other immune-oncology biologics. We are focused on delivering transformative therapies in some of the world's most common cancers, including breast cancer, genitourinary cancer, hematology-oncology, and thoracic cancers, which includes lung cancer. Driven by science, we are committed to accelerating breakthroughs to help people with cancer live better and longer lives. About the Pfizer, Astellas and Merck CollaborationSeagen and Astellas previously entered a clinical collaboration agreement with Merck to evaluate the combination of Seagen's and Astellas' PADCEV™ (enfortumab vedotin) and Merck's KEYTRUDA™ (pembrolizumab) in patients with muscle-invasive bladder cancer (MIBC) who are not eligible for or declined cisplatin-based chemotherapy. Pfizer Inc. successfully completed its acquisition of Seagen on December 14, 2023. KEYTRUDA is a registered trademark of Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Rahway, NJ, USA (known as MSD outside of the United States and Canada). Astellas Cautionary NotesIn this press release, statements made with respect to current plans, estimates, strategies and beliefs and other statements that are not historical facts are forward-looking statements about the future performance of Astellas. These statements are based on management's current assumptions and beliefs in light of the information currently available to it and involve known and unknown risks and uncertainties. A number of factors could cause actual results to differ materially from those discussed in the forward-looking statements. Such factors include, but are not limited to: (i) changes in general economic conditions and in laws and regulations, relating to pharmaceutical markets, (ii) currency exchange rate fluctuations, (iii) delays in new product launches, (iv) the inability of Astellas to market existing and new products effectively, (v) the inability of Astellas to continue to effectively research and develop products accepted by customers in highly competitive markets, and (vi) infringements of Astellas' intellectual property rights by third parties. Information about pharmaceutical products (including products currently in development) which is included in this press release is not intended to constitute an advertisement or medical advice. Pfizer Disclosure NoticeThe information contained in this release is as of August 12, 2025. Pfizer assumes no obligation to update forward-looking statements contained in this release as the result of new information or future events or developments. This release contains forward-looking information about Pfizer Oncology and PADCEV™(enfortumab vedotin) in combination with pembrolizumab in cisplatin-ineligible patients with muscle-invasive bladder cancer, including their potential benefits, and plans to submit results from the Phase 3 EV-303 clinical trial for presentation at an upcoming medical congress and to share the Phase 3 EV-303 clinical trial results with the appropriate regulatory authorities to explore potential regulatory filings that involves substantial risks and uncertainties that could cause actual results to differ materially from those expressed or implied by such statements. Risk and uncertainties include, among other things, uncertainties regarding the commercial success of PADCEV; the uncertainties inherent in research and development, including the ability to meet anticipated clinical endpoints, commencement and/or completion dates for our clinical trials, regulatory submission dates, regulatory approval dates and/or launch dates, as well as the possibility of unfavorable new clinical data and further analyses of existing clinical data; risks associated with interim data; the risk that clinical trial data are subject to differing interpretations and assessments by regulatory authorities; whether regulatory authorities will be satisfied with the design of and results from our clinical studies; whether and when any applications may be filed with regulatory authorities in particular jurisdictions for any potential indication for PADCEV with pembrolizumab or as a single agent; whether and when any applications that may be pending or filed for PADCEV with pembrolizumab or as a single agent may be approved by regulatory authorities, which will depend on myriad factors, including making a determination as to whether the product's benefits outweigh its known risks and determination of the product's efficacy and, if approved, whether PADCEV with pembrolizumab or as a single agent will be commercially successful; decisions by regulatory authorities impacting labeling, manufacturing processes, safety and/or other matters that could affect the availability or commercial potential of PADCEV with pembrolizumab or as a single agent; whether the collaboration between Pfizer, Astellas and Merck will be successful; risks and uncertainties related to issued or future executive orders or other new, or changes in, laws or regulations; uncertainties regarding the impact of COVID-19 on Pfizer's business, operations and financial results; and competitive developments. A further description of risks and uncertainties can be found in Pfizer's Annual Report on Form 10-K for the fiscal year ended December 31, 2024, and in its subsequent reports on Form 10-Q, including in the sections thereof captioned "Risk Factors" and "Forward-Looking Information and Factors That May Affect Future Results", as well as in its subsequent reports on Form 8-K, all of which are filed with the U.S. Securities and Exchange Commission and available at and _________________________ i World Bladder Cancer Patient Coalition. GLOBOCAN 2022: Bladder cancer 9th most common worldwide. Accessed August 11, 2025. Available at: ii Bladder Cancer Awareness Network. What is Muscle Invasive Bladder Cancer? Accessed August 11, 2025. Available at: iii Esteban-Villarrubia J, Torres-Jiménez J, Bueno-Bravo C, García-Mondaray R, Subiela JD, Gajate P. Current and Future Landscape of Perioperative Treatment for Muscle-Invasive Bladder Cancer. Cancers (Basel). 2023 Jan 17;15(3):566. doi: 10.3390/cancers15030566. PMID: 36765525; PMCID: PMC9913718. iv National Institute of Health. National Library of Medicine. Perioperative Pembrolizumab (MK-3475) Plus Cystectomy or Perioperative Pembrolizumab Plus Enfortumab Vedotin Plus Cystectomy Versus Cystectomy Alone in Participants Who Are Cisplatin-ineligible or Decline Cisplatin With Muscle-invasive Bladder Cancer (MK-3475-905/KEYNOTE-905/EV-303. identifier: NCT03924895. Published July 24, 2019. Updated June 17, 2025. Accessed August 11, 2025. Available at: v Challita-Eid PM, Satpayev D, Yang P, et al. Enfortumab vedotin antibody-drug conjugate targeting nectin-4 is a highly potent therapeutic agent in multiple preclinical cancer models. Cancer Res 2016;76(10):3003-13. vi PADCEV [package insert]. Northbrook, IL: Astellas Pharma US, Inc. View source version on Contacts Pfizer Media Contact:PfizerMediaRelations@ +1-212-733-1226Pfizer Investor Contact:IR@ +1-212-733-4848Astellas Contact:Garrett Corporate Communications+81-3-3244-3202 Error in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data