New Data for BAVENCIO® (avelumab) for Advanced Cancers To Be Presented at ESMO 2019

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San Francisco, CA (UroToday.com) — EMD Serono, the biopharmaceutical business of Merck KGaA, Darmstadt, Germany in the US and Canada, and Pfizer Inc. announced the presentation of multiple analyses from the JAVELIN clinical development program assessing BAVENCIO® (avelumab) alone or as part of combination regimens for the treatment of advanced cancers, including renal cell carcinoma (RCC), metastatic Merkel cell carcinoma (mMCC) and some other solid tumors at the European Society for Medical Oncology (ESMO) Congress 2019 in Barcelona, Spain.

  • Analyses from the Phase III JAVELIN Renal 101 study support efficacy of BAVENCIO plus axitinib across multiple subgroups of patients with advanced renal cell carcinoma (RCC)
  • Abstracts highlight data on BAVENCIO as a monotherapy and in combination in multiple advanced cancers

“These data at ESMO underscore the clinical activity of treatment with BAVENCIO across multiple tumor types and patient populations,” said Chris Boshoff, M.D., Ph.D., Chief Development Officer, Oncology, Pfizer Global Product Development. “Furthermore, these presentations demonstrate our commitment to identifying the patients most likely to benefit from this immunotherapy as a single agent, or in combination approaches.”

“The immunotherapy era has led to vast progress in the treatment of cancer, yet we know that many patients with advanced or aggressive cancers still need additional treatment options,” said Luciano Rossetti, Head of Global R&D for EMD Serono. “We are committed to continued research of BAVENCIO as we seek to further advance treatment options for patients with certain cancers.”

Data to be presented at ESMO include three subgroup analyses of the Phase III JAVELIN Renal 101 study (NCT02684006), a randomized, multicenter, open-label study of BAVENCIO in combination with axitinib in 886 patients with untreated advanced RCC from patients across all International Metastatic RCC Database Consortium (IMDC) risk groups. This study, results of which were published in The New England Journal of Medicine in February 2019, demonstrated that BAVENCIO in combination with axitinib significantly improved progression-free survival (PFS) compared with sunitinib in patients with advanced RCC, with a generally acceptable safety tolerability profile, including serious adverse events.1

Results from new analyses of JAVELIN Renal 101 being presented at ESMO, which assessed the effect of BAVENCIO in combination with axitinib in subgroups including patients who did not undergo cytoreductive nephrectomy, patients with sarcomatoid histology, and Japanese patients, are consistent with findings from the overall JAVELIN Renal 101 study population and provide a better understanding of the combination in a broad range of patients with advanced RCC. In May 2019, the U.S. Food and Drug Administration (FDA) approved BAVENCIO in combination with axitinib for the first-line treatment of patients with advanced RCC.2 The Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency (EMA) adopted a positive opinion recommending approval of BAVENCIO in combination with axitinib for the first-line treatment of adult patients with advanced RCC in September 2019.

Presentation #908PD: Phase III JAVELIN Renal 101 Study Subgroup Analysis of Patients with Advanced RCC who did not Undergo Upfront Cytoreductive Nephrectomy
 Sunday, September 29, 15:20 – 15:20: Pamplona Auditorium (Hall 2)

A post-hoc analysis of JAVELIN Renal 101 evaluated patients with advanced RCC who did not undergo prior surgery to remove as much of the visible tumors on the kidneys as possible (cytoreductive nephrectomy), which comprised 20.2% of participants in the study. The findings showed that patients with advanced RCC treated with BAVENCIO in combination with axitinib who did not undergo an upfront cytoreductive nephrectomy experienced greater shrinkage of the primary renal tumor versus sunitinib (≥30% shrinkage for best percent change in renal target lesions from baseline in 34.5% versus 9.7%, respectively).3 The majority of patients with advanced RCC undergo nephrectomy before starting systemic treatment,4 and those who do undergo nephrectomy may experience complications or delays in treatment.5 These results are the first of their kind to report the efficacy of immunotherapy plus a tyrosine kinase inhibitor in patients with advanced RCC when there is still a primary tumor present.3

Presentation #910PD: Phase III JAVELIN Renal 101 Study Subgroup Analysis of Patients with Advanced RCC with Sarcomatoid Histology
 Sunday, September 29, 15:20 – 15:20: Pamplona Auditorium (Hall 2)

A post-hoc analysis of JAVELIN Renal 101 in patients with advanced RCC with sarcomatoid histology, an aggressive subtype of RCC6 that carries the worst prognosis for patients with renal tumors,7,8 included 12.2% of participants in the trial. The results presented at ESMO showed that BAVENCIO plus axitinib improved PFS and objective response rate (ORR) versus sunitinib in patients with advanced RCC with sarcomatoid histology (median PFS: 7.0 months versus 4.0 months, HR 0.57 [95% CI, 0.325-1.003]; median ORR: 46.8% versus 21.3%). These findings provide insight into the biology of sarcomatoid histology and treatment with this immunotherapy in this subgroup of patients.9

Presentation #956P: Phase III JAVELIN Renal 101 Study Subgroup Analysis of Japanese Patients with Advanced RCC
 Monday, September 30, 12:20 – 12:20: Poster Area (Hall 4)

An analysis assessing the efficacy and safety of Japanese patients with advanced RCC (n=67) in JAVELIN Renal 101 study showed that BAVENCIO in combination with axitinib improved median PFS compared to sunitinib in Japanese patients with advanced RCC regardless of PD-L1 expression (16.6 months versus 11.2 months, respectively; HR, 0.66; [95% CI, 0.30-1.46]). Common treatment-emergent adverse events (grade ≥3) in each arm included hand-foot syndrome (9% versus 9%), hypertension (30% versus 18%), and platelet count decreased (0% versus 32%).10 A supplemental application for BAVENCIO in combination with axitinib in unresectable or metastatic RCC was submitted in Japan in January 2019.

Additional presentations at ESMO show the potential impact of BAVENCIO as a monotherapy and as a component of novel combinations: An analysis of health-related quality of life (HRQoL) from the Phase II JAVELIN Merkel 200 study, in which patients with mMCC, an aggressive form of skin cancer with poor outcomes,11 treated with BAVENCIO reported stable or improved HRQoL across various time points (presentation #1320P).12 Interim results from the Phase Ib JAVELIN IL-12 study evaluating BAVENCIO in combination with M9241, EMD Serono’s investigational IL-12 fusion protein containing an anti-DNA antibody, in patients with solid tumors, which informed the recommended dosing for Phase II of this study (presentation #1224P).13 Post-hoc analyses from the JAVELIN Solid Tumor Phase I trial (presentation #1493P)14 and Phase III JAVELIN Lung 200 study (presentation #1492P)15 that further elucidate the effects of BAVENCIO in patients with advanced non-small cell lung cancer.

References

  1. Motzer R, et al. Avelumab plus axitinib versus sunitinib for advanced renal-cell carcinoma. N Engl J Med 2019; 380:1103-1115.
  2. BAVENCIO Prescribing Information. Rockland, MA: EMD Serono Inc.; 2019.
  3. Albiges L, et al. Primary renal tumour shrinkage in patients (pts) who did not undergo upfront cytoreductive nephrectomy (uCN): subgroup analysis from the phase 3 JAVELIN Renal 101 trial of first-line avelumab + axitinib (A + Ax) vs sunitinib (S) for advanced renal cell carcinoma (aRCC). Annals of Oncology. 2019. TBD.
  4. Culp S. Cytoreductive nephrectomy and its role in the present-day period of targeted therapy. Ther Adv Urol. 2015;7(5):275-285.
  5. Silberstein J, et al. Systemic classification and prediction of complications after nephrectomy in patients with metastatic renal cell carcinoma (RCC). BJU Int. 2012;110(9):1276-1282.
  6. Pichler, Renate et al. “Renal Cell Carcinoma with Sarcomatoid Features: Finally New Therapeutic Hope?” Cancers. 2019;11(3):422.
  7. Al-Juhaishi, T et al. “Survival outcomes in sarcomatoid renal cell carcinoma.” Journal of Clinical Oncology.2018;36:15_suppl
  8. American Cancer Society. Survival Rates for Kidney Cancer https://amp.cancer.org/cancer/kidney-cancer/detection-diagnosis-staging/survival-rates.html. Accessed September 2019.
  9. Choueiri T, et al. Efficacy and biomarker analysis of patients (pts) with advanced renal cell carcinoma (aRCC) with sarcomatoid histology (sRCC): subgroup analysis from the phase 3 JAVELIN Renal 101 trial of first-line avelumab plus axitinib (A+ Ax) vs sunitinib (S). Annals of Oncology. 2019. TBD.
  10. Uemura M, et al. Randomized phase 3 trial of avelumab + axitinib vs sunitinib as first-line treatment for advanced renal cell carcinoma: JAVELIN Renal 101 Japanese subgroup analysis. Annals of Oncology. 2019. TBD.
  11. Becker, J.C., Merkel cell carcinoma, Annals of Oncology. 2010: 21, 7_suppl:vii81–vii85
  12. D’Angelo S, et al. Health-related quality of life in patients with metastatic Merkel cell carcinoma receiving second-line or later avelumab treatment: 36-month follow up data. Annals of Oncology. 2019. TBD.
  13. Strauss J, et al. Phase 1b, open-label, dose-escalation study of M9241 (NHS-IL12) plus avelumab in patients (pts) with advanced solid tumors. Annals of Oncology. 2019. TBD.
  14. Hrinczenko B, et al. Long-term avelumab treatment in patients with advanced non-small cell lung cancer (NSCLC): post hoc analyses from JAVELIN Solid Tumor. Annals of Oncology. 2019. TBD.

Source: Serono, EMD. 2019. “New Data for BAVENCIO® (avelumab) for Advanced Cancers to Be Presented at ESMO 2019”. Prnewswire.com.

Further Related Content:
ASCO GU 2019: JAVELIN Renal 101: Outcomes for Avelumab + Axitinib vs Sunitinib in Advanced Renal Cell Carcinoma (RCC)

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