Phase 3
N=886
A Study of Avelumab With Axitinib Versus Sunitinib In Advanced Renal Cell Cancer (JAVELIN Renal 101)
Renal Cell Cancer
Bottom Line
View on ClinicalTrials.gov: NCT02684006 ↗Enrolled (actual)
886
Serious AEs
45.5%
Results posted
Oct 2024
Primary outcome: Primary: Progression Free Survival (PFS) as Assessed by Blinded Independent Central Review (BICR) in Programmed Death-Ligand 1 (PD-L1) Positive Participants — 13.8; 7.2 Months — p=0.0001
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 3
- Interventions
- Avelumab (MSB0010718C) (Drug); Axitinib (AG-013736) (Drug); Sunitinib (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Pfizer
- Primary completion
- Aug 2023
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Progression Free Survival (PFS) as Assessed by Blinded Independent Central Review (BICR) in Programmed Death-Ligand 1 (PD-L1) Positive Participants |
13.8; 7.2 | 0.0001 sig |
| PRIMARY Overall Survival (OS) in PD-L1 Positive Participants |
43.2; 36.2 | 0.1509 |
| SECONDARY PFS as Assessed by BICR in Participants Irrespective of PD-L1 Expression |
13.8; 8.4 | 0.0002 sig |
| SECONDARY OS in Participants Irrespective of PD-L1 Expression |
44.8; 38.9 | 0.1338 |
| SECONDARY Percentage of Participants With Objective Response (OR) as Assessed by BICR Irrespective of PD-L1 Expression |
51.4; 25.7 | — |
| SECONDARY Percentage of Participants With OR as Assessed by Investigator Irrespective of PD-L1 Expression |
59.7; 32.0 | — |
| SECONDARY Percentage of Participants With Disease Control (DC) as Assessed by BICR Irrespective of PD-L1 Expression |
82.8; 73.4 | — |
| SECONDARY Percentage of Participants With DC as Assessed by Investigator Irrespective of PD-L1 Expression |
85.1; 76.4 | — |
| SECONDARY Time to Tumor Response (TTR) as Assessed by BICR in Participants Irrespective of PD-L1 Expression |
2.6; 3.2 | — |
| SECONDARY TTR as Assessed by Investigator in Participants Irrespective of PD-L1 Expression |
2.8; 2.8 | — |
| SECONDARY Duration of Response (DR) as Assessed by BICR in Participants Irrespective of PD-L1 Expression |
NA; NA | — |
| SECONDARY DR as Assessed by Investigator in Participants Irrespective of PD-L1 Expression |
19.4; 14.5 | — |
| SECONDARY PFS as Assessed by Investigator in Participants Irrespective of PD-L1 Expression |
13.9; 8.5 | <.0001 sig |
| SECONDARY Progression-Free Survival on Next-line Therapy (PFS2) in Participants Irrespective of PD-L1 Expression |
30.4; 19.4 | — |
| SECONDARY Number of Participants With Treatment-Emergent Adverse Events (AEs) Graded Based on National Cancer Institute -Common Terminology Criteria for Adverse Events (NCI-CTCAE) Version (V) 4.03 |
5; 17; 64; 73; 271; 268 | — |
| SECONDARY Number of Participants According to Grade Shift in Hematology Parameters |
3; 9; 6; 21; 4; 14 | — |
| SECONDARY Number of Participants According to Grade Shift in Chemistry Parameters |
42; 19; 3; 0; 9; 0 | — |
| SECONDARY Change From Baseline in Vital Signs - Blood Pressure at Day 1 of Cycle 2, 3, 4, 5, 6, 7 and End of Treatment (EOT) Visit |
126.5; 126.3; 4.7; 0.8; 3.8; 1.2 | — |
| SECONDARY Change From Baseline in Vital Signs - Pulse Rate at Day 1 of Cycle 2, 3, 4, 5, 6, 7 and EOT Visit |
75.4; 75.6; 0.4; 3.1; 0.8; 3.1 | — |
| SECONDARY Number of Participants Who Discontinued Treatment Due to Toxicity |
136; 65 | — |
| SECONDARY Time to Treatment Discontinuation/Failure Due to Toxicity |
13.5; 10.5 | — |
| SECONDARY Trough Plasma Concentration (Ctrough) of Avelumab |
4.218; 18.69; 21.99; 24.87; 22.62; 26.04 | — |
| SECONDARY Ctrough of Axitinib |
4.904; 6.272 | — |
| SECONDARY Maximum Plasma Concentration (Cmax) of Axitinib |
17.93; 4.904; 18.45; 6.272; 17.19 | — |
| SECONDARY Number of Participants With Positive PD-L1 Biomarker Expression in Pre-treatment Tumor Tissue |
266; 288 | — |
| SECONDARY PFS in PD-L1 Biomarker-Positive and PD-L1 Biomarker-Negative Subgroups |
13.8; 7.2; 16.1; 11.1 | — |
| SECONDARY Percentage of Participants With OR in PD-L1 Biomarker-Positive and PD-L1 Biomarker-Negative Subgroups |
55.2; 25.5; 47.0; 28.3 | — |
| SECONDARY Percentage of Participants With DC in Biomarker-Positive Subgroup |
84.4; 71.0 | — |
| SECONDARY TTR in Biomarker-Positive Subgroup |
1.6; 3.0 | — |
| SECONDARY DR in PD-L1 Biomarker-Positive and PD-L1 Biomarker-Negative Subgroups |
NA; NA; NA; NA | — |
| SECONDARY Number of Participants With Positive Anti-Drug Antibodies (ADA) and Neutralizing Antibodies (nAb) of Avelumab When Used in Combination With Axitinib |
77; 51 | — |
| SECONDARY Time to Symptom Deterioration (TTD) for Functional Assessment of Cancer Therapy (FACT)-Kidney Symptom Index - Disease Related Symptoms (FKSI-DRS) |
4.2; 6.3 | — |
| SECONDARY Change From Baseline in European Quality of Life (EuroQol) 5-Dimension 5 Levels (EQ-5D-5L) Utility Score |
-0.034; 0.001; -0.023; -0.017; -0.029; -0.022 | — |
| SECONDARY Change From Baseline in EQ-5D Visual Analogue Scale (VAS) Score |
-0.9; -0.2; -0.4; 0.4; -0.1; 0.7 | — |
Summary
This is a phase 3 randomized trial evaluating the anti-tumor activity and safety of avelumab in combination with axitinib and of sunitinib monotherapy, administered as first-line treatment, in patients with advanced renal cell carcinoma
Eligibility Criteria
Inclusion Criteria
- Histologically or cytologically confirmed advanced or metastatic RCC with clear cell component
- Availability of a formalin-fixed, paraffin-embedded (FFPE) tumor tissue block from a de novo tumor biopsy during screening (biopsied tumor lesion should not be a RECIST target lesion). Alternatively, a recently obtained archival FFPE tumor tissue block (not cut slides) from a primary or metastatic tumor resection or biopsy can be provided if the following criteria are met: 1) the biopsy or resection was performed within 1 year of randomization AND 2) the patient has not received any intervening systemic anti-cancer treatment from the time the tissue was obtained and randomization onto the current study. If an FFPE tissue block cannot be provided as per documented regulations then, 15 unstained slides (10 minimum) will be acceptable
- Availability of an archival FFPE tumor tissue from primary tumor resection specimen (if not provided per above). If an FFPE tissue block cannot be provided as per documented regulations 15 unstained slides (10 minimum) will be acceptable
- At least one measurable lesion as defined by RECIST version 1.1 that has not been previously irradiated
- Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1
- Adequate bone marrow function, renal and liver functions
Exclusion Criteria
- Prior systemic therapy directed at advanced or metastatic RCC
- Prior adjuvant or neoadjuvant therapy for RCC if disease progression or relapse has occurred during or within 12 months after the last dose of treatment.
- Prior immunotherapy with IL-2, IFN-α, or anti PD 1, anti PD L1, anti PD L2, anti CD137, or anti cytotoxic T lymphocyte associated antigen 4 (CTLA 4) antibody (including ipilimumab), or any other antibody or drug specifically targeting T cell co stimulation or immune checkpoint pathways
- Prior therapy with axitinib and/or sunitinib as well as any prior therapies with other VEGF pathway inhibitors
- Newly diagnosed or active brain metastasis
- Known severe hypersensitivity reactions to monoclonal antibodies (Grade ≥3), any history of anaphylaxis, or uncontrolled asthma (ie, 3 or more features of partially controlled asthma Global Initiative for Asthma 2011)
- Any of the following in the previous 12 months: myocardial infarction, severe/unstable angina, coronary/peripheral artery bypass graft, symptomatic congestive heart failure, LVEF less than LLN, clinically significant pericardial effusion, cerebrovascular accident, transient ischemic attack
- Any of the following in the previous 6 months: deep vein thrombosis or symptomatic pulmonary embolism
- Vaccination within 4 weeks of the first dose of avelumab and while on trial is prohibited except for administration of inactivated vaccines (for example, inactivated influenza vaccines)
Data sourced from ClinicalTrials.gov (NCT02684006). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.