In the phase III JAVELIN Renal 101 trial, first-line avelumab + axitinib improved progression-free survival (PFS) and objective response rate versus sunitinib in patients with advanced renal cell carcinoma across all International Metastatic RCC Database Consortium (IMDC) risk groups (favorable, intermediate, and poor); analyses of overall survival (OS) remain immature. Here, we report post hoc analyses of efficacy from the third interim analysis (data cut-off, April 2020) by the numbers of IMDC risk factors and target tumor sites at baseline.
Efficacy endpoints assessed were PFS, objective response, and best overall response per investigator assessment (RECIST v1.1) and OS. Best percentage change and percentage change from baseline in target tumor size over time during the study were also assessed.
In patients with 0, 1, 2, 3, or 4-6 IMDC risk factors, hazard ratios [HRs; 95% confidence interval (CIs)] for OS with avelumab + axitinib versus sunitinib were 0.660 (0.356-1.223), 0.745 (0.524-1.059), 0.973 (0.668-1.417), 0.718 (0.414-1.248), and 0.443 (0.237-0.829), and HRs (95% CIs) for PFS were 0.706 (0.490-1.016), 0.709 (0.540-0.933), 0.711 (0.527-0.960), 0.501 (0.293-0.854), and 0.395 (0.214-0.727), respectively. In patients with 1, 2, 3, or ≥4 target tumor sites, HRs (95% CIs) for OS with avelumab + axitinib versus sunitinib were 0.912 (0.640-1.299), 0.715 (0.507-1.006), 0.679 (0.442-1.044), and 0.747 (0.346-1.615), and HRs (95% CIs) for PFS were 0.706 (0.548-0.911), 0.552 (0.422-0.723), 0.856 (0.589-1.244), and 0.662 (0.329-1.332), respectively. Across all subgroups, analyses of objective response rate and complete response rate favored avelumab + axitinib versus sunitinib, and a greater proportion of patients treated with avelumab + axitinib had tumor shrinkage.
In post hoc analyses, first-line treatment with avelumab + axitinib was generally associated with efficacy benefits versus treatment with sunitinib in patients with advanced renal cell carcinoma across subgroups defined by different numbers of IMDC risk factors or target tumor sites.
ESMO open. 2023 Oct 20 [Epub ahead of print]
Y Tomita, R J Motzer, T K Choueiri, B I Rini, H Miyake, M Oya, L Albiges, M Aizawa, Y Umeyama, J Wang, A di Pietro, M Schmidinger
Departments of Urology and Molecular Oncology, Niigata University Graduate School of Medicine, Niigata, Japan. Electronic address: ., Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA., The Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston, MA, USA., Hematology Oncology, Vanderbilt-Ingram Cancer Center, Nashville, TN, USA., Department of Urology, Hamamatsu University School of Medicine, Hamamatsu, Japan., Department of Urology, Keio University School of Medicine, Tokyo, Japan., Department of Oncology, Institut Gustave Roussy, Villejuif, France., Pfizer R&D Japan, Tokyo, Japan., Pfizer, Cambridge, MA, USA., Pfizer srl, Milan, Italy., Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.