Avelumab Prolongs Survival in Advanced Urothelial Cancer

MONDAY, Sept. 21, 2020 — Avelumab added to best supportive care prolongs survival for patients with unresectable local advanced or metastatic urothelial cancer, according to a study published online Sept. 18 in the New England Journal of Medicine. The research was published to coincide with the annual meeting of the European Society for Medical Oncology, held virtually from Sept. 19 to 21.

Thomas Powles, M.D., from Queen Mary University of London, and colleagues randomly assigned 700 patients with unresectable locally advanced or metastatic urothelial cancer who did not have disease progression with first-line chemotherapy to receive best supportive care either with or without maintenance avelumab.

The researchers found that compared with best supportive care alone, the addition of maintenance avelumab to best supportive care significantly prolonged overall survival. At one year, overall survival was 71.3 and 58.4 percent in the avelumab and control groups (median overall survival, 21.4 versus 14.3 months; hazard ratio for death, 0.69), respectively. In the programmed cell death ligand 1 (PD-L1)-positive population, avelumab significantly prolonged overall survival at one year (79.1 versus 60.4 percent, respectively; hazard ratio, 0.56). In the avelumab and control groups, respectively, the median progression-free survival was 3.7 and 2.0 months in the overall population and 5.7 and 2.1 months in the PD-L1-positive population (hazard ratios for disease progression or death, 0.62 and 0.56, respectively).

“We saw a meaningful reduction in the risk of death and a significant overall survival benefit with avelumab, which underscores the potential for this immunotherapy to be practice-changing for patients,” Powles said in a statement.

Several authors disclosed financial ties to Pfizer, which manufactures avelumab and partially funded the study.

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