학술논문

Avelumab monotherapy as first-line or second-line treatment in patients with metastatic renal cell carcinoma: phase Ib results from the JAVELIN Solid Tumor trial
Document Type
Report
Source
Journal for ImmunoTherapy of Cancer. October 24, 2019
Subject
Clinical trials -- Analysis
Avelumab -- Usage
Renal cell carcinoma -- Drug therapy
Death
Bevacizumab
Carcinoma
Cancer
Cancer metastasis
Language
English
ISSN
2051-1426
Abstract
Background Antibodies targeting programmed death-1 (PD-1) or programmed death-ligand 1 (PD-L1) have shown clinical activity in the treatment of metastatic renal cell carcinoma (mRCC). This phase Ib cohort of the JAVELIN Solid Tumor trial assessed the efficacy and safety of avelumab (anti-PD-L1) monotherapy in patients with mRCC as either first-line (1 L) or second-line (2 L) treatment. Methods Patients with mRCC with a clear-cell component who were treatment naive (1 L subgroup) or had disease progression after one prior line of therapy (2 L subgroup) received avelumab 10 mg/kg intravenous infusion every 2 weeks. Endpoints included confirmed best overall response, duration of response (DOR), progression-free survival (PFS), overall survival (OS), PD-L1 expression, and safety. Results A total of 62 patients were enrolled in the 1 L subgroup, and 20 patients were enrolled in the 2 L subgroup. In the 1 L and 2 L subgroups, confirmed objective response rates were 16.1 and 10.0%, median DOR was 9.9 months (95% confidence interval [CI], 2.8-not evaluable) and not evaluable (95% CI, 6.9-not evaluable), median PFS was 8.3 months (95% CI, 5.5-9.5) and 5.6 months (95% CI, 2.3-9.6), and median OS was not evaluable (95% CI, not evaluable) and 16.9 months (95% CI, 8.3-not evaluable), respectively. Treatment-related adverse events (TRAEs) of any grade occurred in 51 patients in the 1 L subgroup (82.3%) and 14 patients in the 2 L subgroup (70.0%). Grade [greater than or equai to] 3 TRAEs occurred in eight patients in the 1 L subgroup (12.9%) and one patient in the 2 L subgroup (5.0%). No treatment-related deaths occurred. Conclusion Avelumab showed clinical activity and a manageable safety profile in both the 1 L and 2 L treatment setting in patients with mRCC. These data support the use of avelumab in combination with other agents in mRCC. Trial registration ClinicalTrials.gov: NCT01772004; registered 21 January, 2013. Keywords: Avelumab, PD-L1, Renal cell carcinoma, Metastatic, Phase I
Author(s): Ulka Vaishampayan[sup.1] , Patrick Schöffski[sup.2] , Alain Ravaud[sup.3] , Christian Borel[sup.4] , Julio Peguero[sup.5] , Jorge Chaves[sup.6] , John C. Morris[sup.7] , Nuria Kotecki[sup.8] , Martin Smakal[sup.9] , Dongli [...]