856P - Avelumab treatment of metastatic urothelial carcinoma (mUC) in the phase 1b JAVELIN Solid Tumor study: updated analysis with ≥6 months of follow-up...

Date 10 September 2017
Event ESMO 2017 Congress
Session Poster display session
Topics Urothelial Cancers
Cancer Immunology and Immunotherapy
Genitourinary Cancers
Presenter Andrea Apolo
Citation Annals of Oncology (2017) 28 (suppl_5): v295-v329. 10.1093/annonc/mdx371
Authors A.B. Apolo1, J. Ellerton2, J.R. Infante3, M. Agrawal4, M.S. Gordon5, R. Aljumaily6, C.D. Britten7, L. Dirix8, K. Lee9, M.H. Taylor10, P. Schöffski11, D. Wang12, A. Ravaud13, A. Gelb14, J. Xiong15, G. Rosen16, M.R. Patel17
  • 1Genitourinary Malignancies Branch, Center for Cancer Research, National Cancer Institute National Institutes of Health, 20892 - Bethesda/US
  • 2Medical Oncology, Nevada Cancer Research Foundation, Las Vegas/US
  • 3Medical Oncology, Sarah Cannon Research Institute/Tennessee Oncology, 37203 - Nashville/US
  • 4Medical Oncology, Associates in Oncology, Rockville/US
  • 5Medical Oncology, HonorHealth Research Institute, Scottsdale/US
  • 6Hematology/oncology, Oklahoma University Medical Centre, Oklahoma City/US
  • 7Hematology/oncology, Medical University of South Carolina, Charleston/US
  • 8Medical Oncology, Sint-Augustinus Hospital Oncology Centre, Antwerpen/BE
  • 9Medical Oncology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam/KR
  • 10Medical Oncology, The Knight Cancer Institute, Oregon Health & Science University, Portland/US
  • 11General Medical Oncology, University Hospitals Leuven, Leuven/BE
  • 12Hematology/oncology, Henry Ford Hospital, Detroit/US
  • 13Medical Oncology, Hospital Saint-André - Hospital Group Saint-André CHU De Bordeaux, Bordeaux Cedex/FR
  • 14R&d Global Early Development, EMD Serono, Inc., Billerica/US
  • 15Biostatistics, EMD Serono, Inc., Billerica/US
  • 16Research & Development, EMD Serono, Inc., Billerica/US
  • 17Medical Oncology, Florida Cancer Specialists/Sarah Cannon Research Institute, Sarasota/US

Abstract

Background

Avelumab, a human anti–PD-L1 monoclonal antibody, has shown promising efficacy and safety in patients (pts) with mUC. We report an updated analysis of avelumab treatment in 2 cohorts of pts from JAVELIN Solid Tumor (NCT01772004).

Methods

Pts with mUC whose disease had progressed after platinum-based therapy or were cisplatin ineligible received avelumab 10 mg/kg Q2W. Tumors were assessed every 6 weeks by independent review (RECIST v1.1). Endpoints included objective response rate (ORR), duration of response (DOR), progression-free survival (PFS), overall survival (OS), and safety (NCI CTCAE v4.0), and tumor PD-L1 expression. Kaplan-Meier (K-M) method was used to estimate DOR, PFS, and OS.

Results

As of Sep 2016, 249 pts had received avelumab and were followed for ≥6 mos (median 13.6 mos); 43 pts (17.3%) remained on treatment. 13 pts (5.2%) were cisplatin ineligible, including 7 (2.8%) platinum naïve. Confirmed ORR in all pts (n = 249) was 17.3% (95% CI 12.8–22.5; complete response in 4.4%) and the disease control rate was 44.6%. Response was ongoing in 34/43 pts (79.1%), median DOR was 20.1 mos (95% CI 9.7–20.1) and the K-M estimate of DOR of 6 mos was 92.7% (95% CI 79.1–97.6). In evaluable pts (n = 206), ORR in PD-L1+ and PD-L1– subgroups (≥5% tumor cell cut-off) was 25.6% and 13.7%, respectively. Median PFS was 1.6 mos (95% CI 1.4–2.7), median OS was 8.2 mos (95% CI 6.3–10.8), and the K-M OS rate at 12 mos was 41.9% (95% CI 34.8–48.7). 170/249 pts (68.3%) had a treatment-related adverse event (TRAE) of any grade, most commonly infusion-related reaction (23.3%) and fatigue (17.3%). 26 pts (10.4%) had a grade ≥3 TRAE, most commonly fatigue (1.6%), elevated lipase (1.6%), and pneumonitis (1.2%). 43 pts (17.3%) had an immune-related AE (grade ≥3 in 3.6%). 8 pts (3.2%) discontinued avelumab due to a TRAE. There was 1 treatment-related death (pneumonitis).

Conclusions

Avelumab showed durable clinical activity and had a manageable and tolerable safety profile in pts with mUC irrespective of PD-L1 expression. A phase 3 trial of avelumab as maintenance therapy after first-line platinum-based therapy for advanced UC is ongoing.

Clinical trial identification

NCT: NCT01772004 Protocol number: EMR 100070-001

Legal entity responsible for the study

Pfizer Inc., New York, NY, USA and Merck KGaA, Darmstadt, Germany

Funding

Funding was provided by Pfizer Inc., New York, NY, USA and Merck KGaA, Darmstadt, Germany

Disclosure

J.R. Infante: Provided consulting to BioMed Valley Discoveries, Inc. and ARMO BioSciences. M.S. Gordon: Received research funding from EMD Serono and MedImmune. C.D. Britten: Institution has received grants/research support from EMD Serono Inc. and Pfizer Inc. Attended dinner meetings for EMD Serono. M.H. Taylor: Has been an advisor for Blueprint Medicines, and a consultant for Trillium Pharma, Bristol- Myers Squibb. Speaker’s Bureau for Eisai Inc. Received honoraria from Blueprint Medicines, Trillium pharma, Bristol-Myers Squibb, Eisai Inc. P. Schöffski: Honoraria (institutional support): Daiichi Sankyo, Eisai, Eli Lilly, Medpace, Novartis, Swedish Orphan Biovitrium. Consulting or advisory role (institutional support): 6th Element Capital, Adaptimmune, Amcure, AstraZeneca, Bayer, Blueprint Medicines, Boehringer lngelheim, Cristal Therapeutics, Daiichi Sankyo, Eisai, Eli Lilly, Medpace, Novartis, Philogen, Piqur Therapeutics. Consulting or advisory role (institutional): BMS, Epizyme, Genzyme, Ipsen, Loxo Oncology, Nektar, Plexxikon. Speaker\'s Bureau (institutional support): Bayer, Eisai, Eli Lilly, GSK, Novartis, PharmaMar, Swedish Orphan Biovitrium. Research Funding (institutional support): Bayer, Blueprint Medicines, Cobiores nv, Exelixis, GSK, Novartis, Plexxikon. Travel, accommodation, expenses (institutional support): 6th Element Capital, Adaptimmune, Amcure, AstraZeneca, Bayer Blueprint Medicines, Boehringer lngelheim, Cristal Therapeutics, Daiichi Sankyo, Eisai, Eli Lilly, GSK, Medpace. Novartis, PharmaMar, Philogen, Piqur Therapeutics, Swedish Orphan Biovitrium. Travel, accommodation, expenses (institutional): BMS, Epizyme, Genzyme, Ipsen, Loxo Oncology, Nektar, Plexxikon. A. Gelb: Employee of EMD Serono Inc. A.G holds stock in Halozyme Therapeutics. J. Xiong, G. Rosen: Employee of EMD Serono Inc. M.R. Patel: Advisory/Board Member: Guardant. Speaker’s Bureau: Exelixis, Bristol-Myers Squib, Medivation, Genentech and Gilead. All other authors have declared no conflicts of interest.