Efficacy of avelumab + axitinib (A + Ax) versus sunitinib (S) by IMDC risk group in advanced renal cell carcinoma (aRCC): Extended follow-up results from JAVELIN Renal 101.

Authors

null

John B. A. G. Haanen

Netherlands Cancer Institute, Amsterdam, Netherlands

John B. A. G. Haanen , James Larkin , Toni K. Choueiri , Laurence Albiges , Brian I. Rini , Michael B. Atkins , Manuela Schmidinger , Konstantin Penkov , Despina Thomaidou , Jing Wang , Mariangela Mariani , Alessandra Di Pietro , Robert J. Motzer

Organizations

Netherlands Cancer Institute, Amsterdam, Netherlands, Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom, Dana-Farber Cancer Institute, The Lank Center for Genitourinary Oncology, Boston, MA, Department of Cancer Medicine, Gustave Roussy Cancer Campus, University of Paris Sud, Boston, MA, Vanderbilt-Ingram Cancer Center, Nashville, TN, Georgetown Lombardi Comprehensive Cancer Center, Washington, DC, Medical University of Vienna, Vienna, Austria, Private Medical Institution “Euromedservice”, Saint-Petersburg, Russian Federation, Pfizer Hellas, Athens, Greece, Pfizer, Cambridge, MA, Pfizer srl, Milan, Italy, Memorial Sloan Kettering Cancer Center, New York, NY

Research Funding

Pharmaceutical/Biotech Company
Funded by Pfizer as part of an alliance between Merck KGaA, Darmstadt, Germany and Pfizer

Background: In the phase 3 JAVELIN Renal 101 trial (NCT02684006), treatment-naive patients with aRCC receiving A + Ax showed improved progression-free survival (PFS) and objective response rate (ORR) across International Metastatic RCC Database Consortium (IMDC) risk groups (favorable [F], intermediate [I], and poor [P]) compared with patients receiving S. Here we report updated efficacy results for A + Ax vs S by IMDC risk groups from the third interim analysis. Methods: Patients were randomized 1:1 to receive either A (10 mg/kg intravenously every 2 weeks) plus Ax (5 mg orally twice daily) or S (50 mg orally once daily) for 4 weeks (6-week cycle). Patients were categorized per IMDC risk group into F, I, and P subgroups, and outcomes were assessed for F, I, P, and I + P. Overall survival (OS) and PFS, ORR, complete response (CR), and duration of response (DoR) per investigator assessment (RECIST v1.1) were assessed. Results: The study enrolled 886 patients with aRCC. At data cutoff (Apr 2020), median (95% CI) follow-up for OS in the A + Ax was NR (42.2-NE) vs 37.8 (31.4-NE) months with S. The Table shows OS, PFS, ORR, CR, and DOR by IMDC risk group. A + Ax generally showed improved efficacy compared with S across IMDC groups. Conclusions: Consistent with previously reported results from prior interim analyses, extended follow-up confirms the efficacy benefits of A + Ax vs S across IMDC risk groups in patients with aRCC. Patients continue to be followed up for the final OS analysis. Clinical trial information: NCT02684006

IMDC risk group
Favorable

A + Ax
(N = 442)
Favorable

S

(N = 444)
Intermediate

A + Ax

(N = 442)
Intermediate

S

(N = 444)
Poor

A + Ax

(N = 442)
Poor

S

(N = 444)
Intermediate + Poor

A + Ax

(N = 442)
Intermediate + Poor

S

(N = 444)
n
94
96
270
276
73


71
343
347
mOS

(95% CI), mo

HR*

(95% CI)


NE

(NE-NE)

0.66

(0.356-1.22)
NE

(39.8-NE)

Ref
42.2

(33.1-NE)

0.84

(0.649-1.08)
37.8

(29.6-NE)

Ref
21.3

(14.7-33.1)

0.60

(0.399-0.912)
11.0

(7.8-16.5)

Ref
40.0

(30.5-NE)

0.79

(0.636-0.98)
29.5

(24.8-38.0)

Ref
mPFS

(95% CI), mo

HR*

(95% CI)


20.7

(16.6-26.3)

0.71

(0.490-1.02)
13.8

(11.1-23.5)

Ref
12.9

(11.1-16.6)

0.71

(0.578-0.866)
8.4

(7.9-10.1)

Ref
8.7

(5.6-11.1)

0.45

(0.304-0.678)
4.2

(2.8-5.5)

Ref
11.1

(9.8-14.6)

0.66

(0.550-0.787)
8.2

(6.9-8.4)

Ref
ORR

(95% CI), %


75.5

(65.6-83.8)
45.8

(35.6-56.3)
59.6

(53.5-65.5)
31.2

(25.7-37.0)
38.4

(27.2-50.5)
15.5

(8.0-26.0)
55.1

(49.7-60.4)
28

(23.3-33.0)
CR, n (%)
9 (9.6)
5 (5.2)
11 (4.1)
8 (2.9)
1 (1.4)
1(1.4)
12 (3.5)
9 (2.6)
DoR

(95% CI), mo
22.6

(15.2-31.7) (n = 71)
20.8

(14.5-24.9) (n = 44)
19.3

(13.9-22.1)

(n = 161)
12.5

(7.1-16.6)

(n = 86)
18.2

(6.8-NE)

(n = 28)
5.6

(2.5-8.3) (n = 11)
19.3

(13.9-22.1) (n = 189)
9.8

(7.0-15.3) (n = 97)

m, median; mo, months; NE, not estimable; HR, hazard ratio; Ref, reference. * Unstratified.

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Abstract Details

Meeting

2021 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Genitourinary Cancer—Kidney and Bladder

Track

Genitourinary Cancer—Kidney and Bladder

Sub Track

Kidney Cancer

Clinical Trial Registration Number

NCT02684006

Citation

J Clin Oncol 39, 2021 (suppl 15; abstr 4574)

DOI

10.1200/JCO.2021.39.15_suppl.4574

Abstract #

4574

Poster Bd #

Online Only

Abstract Disclosures