Early Results Positive for First-Line Avelumab in NSCLC


“Treatment with first-line avelumab yielded promising clinical benefit and durable antitumor activity in patients with advanced non–small cell lung cancer (NSCLC), according to a presentation at the IASLC 17th World Conference on Lung Cancer.

“After a median follow-up of 13 weeks, the objective response rate with the anti-PD-L1 immunotherapy agent was 22.4% (95% CI, 16.2-29.8) and the median progression-free survival (PFS) was 17.6 weeks (95% CI, 11.6-23.6) among 156 patients who participated in one of the NSCLC cohorts of the wide-ranging JAVELIN Solid Tumor trial, Claire Verschraegen, MD, director, The University of Vermont Cancer Center, said in describing early analysis data at the conference in Vienna.”

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Avelumab Promising in Unresectable Mesothelioma


“The novel anti-PD-L1 agent avelumab showed some promising clinical activity and was generally well tolerated in a phase I trial of patients with unresectable, previously treated mesothelioma. Results of the trial were presented at the American Society of Clinical Oncology (ASCO) Annual Meeting, held June 3–7 in Chicago.

“ ‘Approximately 3,000 new cases of malignant mesothelioma are diagnosed each year in the United States,’ said Raffit Hassan, MD, of the National Cancer Institute in Bethesda, Maryland, who presented the study. The current standard treatment of pemetrexed and cisplatin yields a median overall survival of 12.1 months, and there is no US Food and Drug Administration (FDA)-approved therapy for patients progressing after first-line chemotherapy.

“Avelumab is a fully human anti-PD-L1 IgG1 antibody; it is under investigation in multiple malignancies. PD-L1 is expressed on the surface of mesothelioma cells, providing a rationale for avelumab’s use in this malignancy. In the new JAVELIN study, more than 1,600 patients have been treated with the drug across a variety of malignancies; in this analysis, 53 patients with unresectable pleural or peritoneal mesothelioma were included. All patients had progressed after a platinum/pemetrexed-containing regimen; they were unselected for PD-L1 expression.”

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Putting Immune Checkpoint Blockade to the Test in Breast Cancer

About 10 months ago, we asked: Is There a Future for Immunotherapy in Breast Cancer? Now, we can answer this question with a qualified “yes.” The data show why:

Triple-negative breast cancer (TNBC)

TNBC has long been considered to be more amenable to immune system-based treatments than other types of breast cancer because it is more immunogenic; that is, relatively high levels of immune cells accumulate within or adjacent to TNBC tumors. These immune cells could be triggered to attack tumors if properly activated. TNBC tumors are also likely to have a higher mutational burden (number of genetic mutations). This is one of the predictors of sensitivity to a type of treatment called immune checkpoint blockade.  Drugs known as checkpoint inhibitors block the proteins PD-1 or PD-L1. In cancer, PD-L1 proteins on tumor cells bind to PD-1 proteins on immune T cells and inhibit their tumor-killing activity. Immune checkpoint drugs disable this interaction and enable activation of T cells. These drugs are actively being explored in TNBC in clinical trials.

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Video: Dr. Saeed Rafii on the Phase Ib JAVELIN Trial Examining Avelumab in Breast Cancer

“Saeed Rafii, MD, PhD, MRCP, medical oncologist, medical director, Sarah Cannon Research Institute, London, discusses the phase Ib JAVELIN solid tumor trial. The trial looks at the anti-PD-L1 antibody avelumab (MSB0010718C) in patients with locally advanced or metastatic breast cancer. Rafii said the trial looked at 168 patients, regardless of the subtype of their breast cancer.

“Patients enrolled in the trial must have had 3 or fewer lines of chemotherapy prior to receieving avelumab. Rafii said of the patients, 10% experiences immune-related events. He also added that 8 patients had to stop due to treatment-related toxicities and that there were 2 mortalities. One of the 2 mortalities were from acute hepatic failure and another from respitority distress.”

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