Disitamab vedotin (DV), a HER2-targeted antibody–drug conjugate, produced robust response rates in a phase 2 RC48G001 study of previously treated locally advanced or metastatic urothelial carcinoma. Results presented at the ASCO Genitourinary Cancers Symposium reported confirmed overall response rates of 54.9% in the HER2-positive cohort and 52.6% in the HER2-low cohort, with median progression-free survival of 5.7 months in both groups and median overall survival around 17–20 months. The data suggest DV may expand HER2-directed options beyond trastuzumab deruxtecan and support global development programs outside China. Clinicians noted DV’s distinct MMAE payload and comparable activity across HER2 expression levels; broader registrational plans and comparative positioning with existing HER2 agents will determine its eventual role in urothelial carcinoma treatment.