Journal article
Response and Outcomes of Maintenance Avelumab After Platinum-Based Chemotherapy (PBC) in Patients With Advanced Urothelial Carcinoma (aUC): “Real World” Experience
Clinical genitourinary cancer, Vol.21(5), pp.584-593
10/01/2023
DOI: 10.1016/j.clgc.2023.06.008
PMCID: PMC11289267
PMID: 37414620
Abstract
Platinum-based chemotherapy (PBC) followed by avelumab switch maintenance in nonprogressors is standard first line (1L) treatment for advanced urothelial carcinoma (aUC). We describe clinical features and outcomes in a “real-world’ cohort treated with avelumab maintenance for aUC.
This was a retrospective cohort study of patients (pts) who received 1L switch maintenance avelumab after no progression on PBC for aUC. We calculated progression-free survival (PFS) and overall survival (OS) from initiation of maintenance avelumab. We also described OS and PFS for specific subsets using Cox regression and observed response rate (ORR).
A total of 108 pts with aUC from 14 sites treated with maintenance avelumab were included. There was a median of 6 weeks1-30 from end of PBC to avelumab initiation; median follow-up time from avelumab initiation was 8.8 months (1-42.7). Median [m]PFS was 9.6 months (95%CI 7.5-12.1) and estimated 1-year OS was 72.5%. CR/PR (vs. SD) to 1L PBC (HR = 0.33, 95% CI 0.13-0.87) and ECOG PS 0 (vs. ≥1), (HR = 0.15, 95% CI 0.05-0.47) were associated with longer OS. The presence of liver metastases was associated with shorter PFS (HR = 2.32, 95% CI 1.17-4.59). ORR with avelumab maintenance was 28.7% (complete response 17.6%, partial response 11.1%), 29.6% stable disease, 26.9% progressive disease as best response (14.8% best response unknown).
Results seem relatively consistent with findings from JAVELIN Bladder100 trial and recent “real world” studies. Prior response to platinum-based chemotherapy, ECOG PS 0, and absence of liver metastases were favorable prognostic factors. Limitations include the retrospective design, lack of randomization and central scan review, and possible selection/confounding biases.
Based on JAVELINBladder100 trial, avelumab maintenance was approved for patients with advanced urothelial carcinoma (aUC) without progression on first-line platinum-based chemotherapy. We examined patient characteristics, prognostic factors and outcomes in patients who received avelumab switch maintenance in a “real-world” (outside trials) setting. Our results appear similar with those from the clinical trial and recent “real world” studies.
Details
- Title: Subtitle
- Response and Outcomes of Maintenance Avelumab After Platinum-Based Chemotherapy (PBC) in Patients With Advanced Urothelial Carcinoma (aUC): “Real World” Experience
- Creators
- Dimitra Rafailia Bakaloudi - University of Washington Medical CenterRafee Talukder - University of Washington Medical CenterGenevieve Ihsiu Lin - University of WashingtonDimitrios Makrakis - Jacobi Medical CenterLeonidas N. Diamantopoulos - University of PittsburghNishita Tripathi - University of UtahNeeraj Agarwal - University of UtahRoubini Zakopoulou - National and Kapodistrian University of AthensAristotelis Bamias - National and Kapodistrian University of AthensJason R. Brown - University Hospitals Seidman Cancer CenterDavid J. Pinato - Imperial College LondonJames Korolewicz - Hammersmith HospitalTanya Jindal - UCSF Helen Diller Family Comprehensive Cancer CenterVadim S. Koshkin - UCSF Helen Diller Family Comprehensive Cancer CenterJure Murgić - University Hospital Centre ZagrebMarija Miletić - University Hospital Centre ZagrebAna Frobe - Department of Oncology and Nuclear Medicine, Faculty of Dentistry, University Hospital Center Sestre Milosrdnice, Zagreb, CroatiaJeffrey Johnson - University of IowaYousef Zakharia - University of IowaAlexandra Drakaki - University of California, Los AngelesAlejo Rodriguez-Vida - Hospital Del MarMacarena Rey-Cárdenas - Hospital Universitario 12 De OctubreDaniel Castellano - Hospital Universitario 12 De OctubreLucia Alonso Buznego - Marqués de Valdecilla University HospitalIgnacio Duran - Instituto de Investigación Marqués de ValdecillaClara Castro Carballeira - Marqués de Valdecilla University HospitalRafael Morales Barrera - Vall d'Hebron Hospital UniversitariDavid Marmorejo - Vall d'Hebron Hospital UniversitariRana R. McKay - University of California San DiegoTyler Stewart - University of California San DiegoShilpa Gupta - Cleveland ClinicAndrew Thomas Ruplin - Department of Pharmacy, Fred Hutchinson Cancer Center, Seattle, WAEvan Y. Yu - University of Washington Medical CenterAli R. Khaki - Stanford UniversityPetros Grivas - Fred Hutch Cancer Center
- Resource Type
- Journal article
- Publication Details
- Clinical genitourinary cancer, Vol.21(5), pp.584-593
- DOI
- 10.1016/j.clgc.2023.06.008
- PMID
- 37414620
- PMCID
- PMC11289267
- NLM abbreviation
- Clin Genitourin Cancer
- ISSN
- 1558-7673
- eISSN
- 1938-0682
- Publisher
- Elsevier Inc
- Language
- English
- Date published
- 10/01/2023
- Academic Unit
- Hematology, Oncology, and Blood & Marrow Transplantation; Internal Medicine
- Record Identifier
- 9984544949802771
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