Judy Wells was puzzled by the pain in her stomach. It was her first day of retirement after 47 years as a registered nurse in Laurel, Mississippi. At age 69, she planned to continue her passion for baking pastries, beekeeping, and helping people who are ill and confined to their homes.
She finally went to the hospital, where a PET scan revealed a suspicious lesion in her right kidney. A biopsy by a urologist in nearby Hattiesburg brought grave news: She had high-grade urothelial carcinoma of the kidney — a rare form of kidney cancer and a close cousin of bladder cancer. (Although the cancer did not affect the bladder itself, doctors treat it the same as bladder cancer.)
“It didn’t make sense — I’ve always been healthy and very, very active, so this came out of nowhere,” she says.
The metastatic cancer had already spread to nearby lymph nodes and the tumor was beginning to press against her spine. Her kidney, swollen far beyond its normal size, had to come out. It was August 2024.
When Judy posted a note on Facebook that she was having surgery in Hattiesburg, a friend reached out with an urgent message.
“Mary Pat told me right out, ‘You’re not having your kidney out before you come for a second opinion at Memorial Sloan Kettering,’ ” Judy recalls. “She made it clear there would be no debate.”
Looking back, she’s glad she took the advice to travel to Memorial Sloan Kettering Cancer Center (MSK), where she got a second opinion on her cancer diagnosis. The decision — which gave her access to the highest levels of cancer expertise, along with the latest treatments — saved her life.
MSK Offers New Treatment for Inoperable Urothelial Carcinoma
Less than a week after calling MSK to make an appointment, Judy was meeting with MSK urologic surgeon A. Ari Hakimi, MD, and genitourinary medical oncologist David H. Aggen, MD, PhD. Dr. Hakimi has vast experience in urologic surgery, including expertise in minimally invasive procedures. Dr. Aggen has been active in developing new therapies and clinical trials for people with urothelial carcinoma, especially finding ways to use immunotherapy in cancer treatment.
Dr. Hakimi and Dr. Aggen have published extensively on the genetic factors of bladder and kidney cancers and figuring out which treatment — immunotherapy, targeted therapy, chemotherapy, or some combination — is most likely to benefit a patient.
Dr. Hakimi told Judy he consulted with other MSK doctors about removing her kidney, a team approach which is standard at MSK, and everyone agreed that in her current state she wouldn’t survive more than a few months.
Instead, he and Dr. Aggen proposed that she switch to a new urothelial carcinoma treatment: an antibody-drug conjugate called enfortumab vedotin (Padcev®) combined with the immunotherapy drug pembrolizumab (Keytruda®). They hoped this would shrink the main tumor until it could be surgically removed.
How Antibody-Drug Conjugates Attack Cancer Cells
Antibody-drug conjugates treat cancer by combining three parts:
- An antibody that binds to specific proteins or receptors on the surface of the cancer cell.
- A drug, such as chemotherapy, that is toxic to the cancer cell.
- A linker that connects the drug and antibody, keeping the drug bound to the antibody until the duo arrives at the cancer cell to destroy it.
MSK’s History Developing the Combination Therapy for Urothelial Carcinoma
The U.S. Food and Drug Administration (FDA) had approved the enfortumab vedotin and pembrolizumab (EV+P) combination in 2023 for people who, like Judy, are newly diagnosed with metastatic urothelial carcinoma. MSK played a key role in clinical research supporting the FDA approval, with genitourinary oncologist and bladder cancer specialist Jonathan Rosenberg, MD, leading multiple clinical trials.
Judy’s Experience on Enfortumab Vedotin and Pembrolizumab
Judy agreed to try the combination therapy. A woman of strong faith, she asked Dr. Hakimi if she was going to live.
“He said, ‘Well aren’t you a Bible-believing lady?’ I said I was, and he said, ‘Go home and pray, and get others to pray for you. Take this medicine and come back in a few months and we’ll do another PET scan and go from there.’ ”
Judy received six cycles of the EV+P therapy during the last few months of 2024 back home in Laurel. She struggled at first, losing 55 pounds and feeling very weak, but she relied on her faith, family, and close friends, who stayed with her several days a week.
“When I was a nurse all those years, I helped a lot of very sick patients, ministering to them and giving them encouragement along the way,” she says. “Now after 47 years, I was on the other side, and people were taking care of me.”
Stage 4 Urothelial Carcinoma Disappears With Combination Treatment
Six months after her life-threatening diagnosis, the therapy started taking hold. In January 2025, Judy began regaining her energy and felt much better. That month, she returned to MSK with her family for a follow-up PET scan.
Dr. Aggen sat them down in his office.
“He put the old PET scan on the screen, and it showed my kidney was huge and glowing like a light bulb with cancer cells everywhere, including the lymph nodes,” Judy says. “Then he put up the new scan, and there was nothing lit up. He said, ‘I don’t see any cancer anywhere. You have had amazingly remarkable results.’ I was overflowing with gratitude.”
“We are now seeing exceptional responses with new combination therapy, in some cases, where selected patients can now be offered surgery with the goal of cure, which would have been unthinkable just a few years ago,” Dr. Aggen says.
Although the urothelial carcinoma tumor had disappeared, to make sure there were no lingering cancer cells, Dr. Hakimi removed Judy’s kidney, the ureter, and part of the bladder in a five-hour procedure in March. He also removed 50 lymph nodes to check for remaining cancer. There was none.
“Dr. Hakimi told me, ‘Judy, I can’t find cancer anywhere,’” she recalls. “You have to understand — you are the first to have a 100% cure for this type of urothelial cancer using EV and pembrolizumab.’ He was as excited as I was.”
After the surgery, Judy stopped the EV+P combination, but she continues to take pembrolizumab alone to reduce the risk of the cancer returning. Another PET scan in June showed no evidence of disease.
Back to Life As a Cancer Survivor
Judy is back home doing the things she loves with her husband, continuing to bake goodies for the homebound, for fundraisers, and for other charities. Spending time with her three children and 10 grandchildren who live in the area brings her boundless joy.
Judy also spreads her passion for beekeeping, by selling honey at local events and displaying a bee colony to teach lessons on how each colony thrives. Children who remember “bee facts” are rewarded with gifts. She wants to inspire children, especially girls, to become beekeepers.
“There are not many women who want to be in the profession because of its dangerous nature,” she says. “But there’s nothing better than seeing that liquid gold come out when you’re extracting honey from the comb.”
Life is golden for Judy these days. She is extremely grateful to MSK and Drs. Aggen and Hakimi.
“I feel blessed by my family and friends and my Lord and Savior Jesus Christ, which sustained me through the dark times,” she says.
“When this started, I had a vision of a big fire in front of me,” she says. “My family and friends were like crutches, and the doctors gathered around and held me up, and God was standing in front of me, and he pulled me all the way through until I stood on the other side.”
As important to her as her faith, she says, her excellent outcome after cancer is the result of finding the best place for treatment, even if it means traveling a long distance.
“Every time I went up to see Dr. Hakim and Dr. Aggen, I was so grateful and thankful for the love and kindness and caring they gave to me,” she says. “I want to give hope and encouragement to others who have stage 4 cancer, to let them know about the advances that are happening, and to let them know that MSK is an absolutely fabulous place to go when you need help.”
Prognosis for Urothelial Carcinoma Improves With Antibody-Drug Conjugate: Key Takeaways
- Urothelial carcinoma primarily arises in the bladder but can affect the kidneys and other parts of the urinary system.
- New treatments called antibody-drug conjugates, combined with immunotherapy, have been effective for treating urothelial carcinoma even after it has spread to lymph nodes.
- MSK played a key role in clinical research supporting FDA approval of the enfortumab vedotin and pembrolizumab (EV+P) combination, in 2023, for newly diagnosed metastatic urothelial carcinoma, with genitourinary oncologist and bladder cancer specialist Jonathan Rosenberg, MD, leading multiple clinical trials.
- Certain patients with late-stage urothelial carcinoma who respond well to the combination treatment can now be offered surgery with the goal of being cured.