Updated efficacy and safety of avelumab in metastatic urothelial carcinoma (mUC): Pooled analysis from 2 cohorts of the phase 1b Javelin solid tumor study.

Authors

Andrea Apolo

Andrea B. Apolo

Genitourinary Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD

Andrea B. Apolo , John Allan Ellerton , Jeffrey R. Infante , Manish Agrawal , Michael S. Gordon , Raid Aljumaily , Carolyn D. Britten , Luc Yves Dirix , Keun-Wook Lee , Matthew H. Taylor , Patrick Schöffski , Ding Wang , Alain Ravaud , Arnold Gelb , Junyuan Xiong , Galit Rosen , Manish R. Patel

Organizations

Genitourinary Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, Nevada Cancer Research Foundation, Las Vegas, NV, Sarah Cannon Research Institute and Tennessee Oncology, PLLC, Nashville, TN, Associates in Oncology, Rockville, MD, Pinnacle Oncology Hematology, A Division of Arizona Center for Cancer Care, HonorHealth Research Institute Clinical Trials Program at the Virginia G. Piper Cancer Center, Scottsdale, AZ, Oklahoma University Medical Center, Oklahoma City, OK, Medical University of South Carolina, Charleston, SC, Sint-Augustinus Hospital, Antwerpen, Belgium, Seoul National University Bundang Hospital, Seongnam, South Korea, Knight Cancer Institute, Oregon Health & Science University, Portland, OR, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium, Henry Ford Health System, Detroit, MI, Groupe Hospitalier Saint Andre - Hopital Saint Andre, Bordeaux Cedex, France, EMD Serono, Inc., Billerica, MA, Florida Cancer Specialists and Research Institute, Sarasota, FL

Research Funding

Pharmaceutical/Biotech Company

Background: Avelumab, a fully human anti‒PD-L1 IgG1 antibody, has shown promising efficacy and safety in 2 cohorts of patients (pts) with mUC. We now report updated data from a pooled analysis of these pts with mUC from JAVELIN Solid Tumor (NCT01772004) and further characterize the clinical activity of avelumab in this disease. Methods: Pts with mUC progressed after platinum-based therapy or cisplatin ineligible received avelumab 10 mg/kg 1-hour IV 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), safety (NCI CTCAE v4.0), and tumor PD-L1 expression. Results: As of Jun 9, 2016, 249 pts had received avelumab for a median of 12 weeks (range 2-92) and were followed up for a minimum of 6 weeks. Primary tumor site was upper tract (renal pelvis/ureter) in 23.3% and lower tract (bladder/urethra) in 76.7%. 242 pts (97.2%) had progressed on prior platinum therapy and 7 pts (2.8%) were platinum naive. In 161 post-platinum pts with ≥6 months of follow-up, confirmed ORR was 17.4% (95% CI 11.9-24.1; complete response in 6.2%) with a disease control rate of 39.8%. Response was ongoing in 23/28 responders at data cut (82.1%; median DOR not reached), and the 24-week durable response rate was 92.3% (95% CI 72.6-98.0). Responses occurred across PD-L1 expression levels tested (≥5% and < 5% tumor cell‒staining [25.4% and 13.2%]). In all post-platinum pts (n = 242), median PFS was 6.6 weeks (95% CI 6.1-11.6), median OS was 7.4 months (95% CI 5.7-10.3) and 6-month OS rate was 54.9 (95% CI 47.7-61.7). Treatment-related adverse events (TRAE) of any grade occurred in 166/249 pts (66.7%); most common (≥10%) were infusion-related reaction (22.9%, all grade ≤2) and fatigue (16.1%). 21 pts (8.4%) had a grade ≥3 TRAE (fatigue [1.6%] and asthenia [0.8%] in > 1 pt). 34 pts (13.7%) had an immune-related AE (grade ≥3 in 2.4%). There was 1 treatment-related death (pneumonitis). Conclusions: Avelumab was well tolerated and showed durable responses in heavily pretreated pts with mUC, irrespective of tumor PD-L1 expression status. Clinical trial information: NCT01772004

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Abstract Details

Meeting

2017 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Genitourinary (Nonprostate) Cancer

Track

Genitourinary Cancer—Kidney and Bladder

Sub Track

Bladder Cancer

Clinical Trial Registration Number

NCT01772004

Citation

J Clin Oncol 35, 2017 (suppl; abstr 4528)

DOI

10.1200/JCO.2017.35.15_suppl.4528

Abstract #

4528

Poster Bd #

206

Abstract Disclosures