ASCO 2020 advanced urinary skin cancer has made new progress, Avelumab maintenance treatment combined BSC can extend the total survival period by 7.1 months!

The 2020 Annual Meeting of the American Society of Clinical Oncology (ASCO) is drawing to a close, and this academic feast has won the attention of oncologists around the worldThe most-watched summary of the study (Late-breaking Abstract, LBA) was officially released at 5 p.mEST on May 28, with two entries for abstractoral session and five for LBA plenary sessionFollow in the footsteps of small editors and open the cloud year mode, and take a look at these heavyweight studiesthis issue is an LBA (summary number LBA1) selected for plenary session, which reports the mid-stage analysis of a combination of therapeutic clinical trials (JAVEL) (JAVEL) for advanced urinary skin cancer (UC) patients who received platinum chemotherapy using the anti-PD-L1 drug Avelumab (BVencio) to maintain therapy( BSC), compared with a simple BSCthis trial found that the use of Avelumab maintenance therapy could extend the median total survival of advanced UC patients by 7.1 monthsstudy background
urinary skin cancer (UC), the most common type of bladder cancer, is now the sixth most commoncancerin the United States, with about 200,000 deaths worldwide in 2018Although most patients with advanced UC have a disease control rate (DCR) of about 65% to 75% after first-line platinum chemotherapy, their disease-free survival (PFS) and total survival (OS) tend to be shorter due to the presence of chemotherapy resistanceAfter first-line chemotherapy, only about 25% to 55% of patients have the opportunity to receive second-line treatment, but many second-line treatment outcomes due to rapid progress of the disease, and failed to meet the standard of treatmentPD-L1/PD-1 inhibitors are often used as second-line therapeutic drugs after first-line platinum chemotherapy in patients with disease progression, including PD-L1 inhibitor AvelumabAlthough PD-L1/PD-1 inhibitors have anti-tumor activity in UC, only a small number of patients can benefit from lasting clinical benefits in second-line therapy, and Avelumab maintenance therapy is an attractive treatment strategy for patients who have not progressed in 1-line platinum-induced chemotherapyDisease control through chemotherapy may extend the anti-tumor effect of immunotherapy, and starting immunotherapy before the disease progresses will lead to extended treatment in more patients research methods included 700 eligible patients with non-rectrusised local late or metastatic UC and no disease progression, who had been treated with 4-6 cycles of Gisitabin and Cisiplatin or Gisitamandandand and Caplatinum, and were randomly assigned to Ave at 1:1 Lumab maintenance therapy (intravenous 10 mg/kg, every 2 weeks) combined BSC or single BSC, when starting first-line chemotherapy, is layered according to the best response to first-line chemotherapy (full/partial response vs stable disease) and visceral disease vs non-visceral disease The primary endpoint of is OS , which is evaluated through randomization in two main populations: all randomized patients and Patients with PD-L1 plus tumors (Ventana SP263 analysis); results Avelumab maintenance therapy (intravenous lysing 10 mg/kg, every 2 weeks) combined BSC (n-350) and single BSC (n-350) for patients with an average follow-up time of 19.6 months and 19.2 months, respectively Figure 3 baseline characteristics overall, 358 patients (51%) had PD-L1 plus tumors Compared to single BSC therapy, avelumab-BSC combination therapy significantly extended the OS (risk ratio (HR) 0.69; 95% CI 0.56, 0.86; single-sided P-0.0005) and the median OS treated by Avelumab and BSC and BSC were 21.4 months and 14.3 months, respectively Avelumab and BSC also significantly extended OS (HR 0.56; 95% CI 0.40, 0.79; one-sided P-0.0003), with median OS not reaching and 17.1 months, respectively OS benefits were also observed in all pre-specified subgroups Figure 4 Total Lifetime Analysis of the Population a separate center assessment of the Blind Method based on Avelumab and BSC and BSC alone resulted in a PFS HR of 0.62 (95% CI 0.52,0.75) for all random patients and 0.56 (95% CI 0.43, 0.73) in PD-L1 plus tumor patients In patients in the Averumab-BSC combination therapy group (n-BSC) and the BSC individual treatment group (n-345), the all levels of all-cause adverse events (AEs) were 98.0% vs 77.7% and 47.4% vs 25.2%, and most common level 3 adverse events are urinary tract infection (4.4 percent vs 2.6 percent), anemia (3.8 percent vs 2.9 percent), blood urine (1.7 percent vs 1.4 percent), fatigue (1.7 percent vs 0.6 percent) and back pain (1.2 percent vs 2.3 percent) expanded thinking the above test showed that the JAVELIN Bladder 100 trial reached its main end in the study, that is, in all randomized and PD-L1-positive advanced UC patients, the use of Avelumab maintenance after first-line chemotherapy combined BSC compared to single BSC can significantly extend OS, and Avelumab's safety is consistent with previous single-drug therapy studies Avelumab became the fourth approved PD-1/PD-L1 antibody to be approved for treatment of metastatic merkel cell carcinoma on March 23, 2017 Avelumab is the only strong ADCC-active PD-1/PD-L1 antibody, so it can use strong ADCC-active mediated NK cells to kill cancer cells while relieving cancer cells from immune escape this trial confirmed the advantages of Avelumab maintenance therapy in immunotherapy through comparative analysis, but the study of Avelumab treatment in the past cancerous tumors has failed End of 2017, Avelumab's phase III GAStric gastric 300 study failed, and the study found that using Avelumab's third-line treatment of gastric cancer alone did not significantly improve the overall survival of patients compared to the chemotherapy drugs chosen by doctors In February 2018, Avelumab's study of Lung Cancer Phase III, JAVELIN Lung 200, showed that Avelumab's second-line therapy did not significantly improve THE OS in patients with PD-L1 positive (PD-L1 expression level of 1%), compared to dositarace In December 2018, a maintenance therapy trials for acombination/or platinum chemotherapy for treatment of patients with stage III or stage IV epithelial ovarian cancer with out-of-treatment local progression or metastasis were terminated because the interim analysis of the study (JAVELIN Ovarian 100) found that initial hypothesis was not supported despite having encountered Waterloo, there is more to the exploration of Avelumab, and the therapeutic effects in the late UC reported by this ASCO conference are encouraging and it is believed that Avelumab is still the star of the future to be expected author: Tao Ran Source: health