Safety And Efficacy Study Of Avelumab Plus Chemotherapy With Or Without Other Anti-Cancer Immunotherapy Agents In Patients With Advanced Malignancies

NCT ID: NCT03317496

Last Updated: 2023-08-29

Study Results

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Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

PHASE1/PHASE2

Total Enrollment

67 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-12-21

Study Completion Date

2022-12-20

Brief Summary

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This is a Phase 1b/2, open label, multicenter, safety and clinical activity study of avelumab in combination with chemotherapy as first-line treatment of adult patients with locally advanced or metastatic solid tumors. Initially, avelumab will be evaluated in combination with pemetrexed and carboplatin in patients with advanced non-squamous non-small cell lung cancer (NSCLC) (Cohort A1) and in combination with gemcitabine and cisplatin in patients with cisplatin-eligible urothelial (bladder) cancer (UC) (Cohort A2). As more information is learned about other anti-cancer immunotherapy agents, in future portions of the study, avelumab may be combined with chemotherapy and other anti-cancer immunotherapy agents in patients with these same or different tumor types.

Detailed Description

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This is a Phase 1b/2, open label, multicenter, safety, clinical activity, pharmacokinetic (PK), and pharmacodynamics (PD) study of avelumab in combination with chemotherapy with or without other anti-cancer immunotherapies, as first-line treatment of adult patients with locally advanced or metastatic solid tumors. Initially, avelumab will be evaluated in combination with pemetrexed and carboplatin in patients with advanced non-squamous non-small cell lung cancer (NSCLC) (Cohort A1) and with gemcitabine and cisplatin in patients with cisplatin-eligible urothelial cancer (UC) (Cohort A2).

Given the growing preclinical and clinical indications that combinations of anti-cancer immunotherapies potentially improve patient outcomes compared to results seen with single agents, in portions of the study to be added in the future, avelumab will be evaluated in combination with both standard-of-care chemotherapy and other anti-cancer immunotherapies in patients with advanced malignancies. Each cohort in the study will consist of a Phase 1b lead-in portion to evaluate safety and a Phase 2 cohort expansion to evaluate safety and efficacy.

In the Phase 1b safety lead-in portion, up to 12 patients will be enrolled into each cohort and evaluated for dose-limiting toxicities (DLT) during the first 2 cycles of treatment. If investigational products administration in a cohort is deemed safe in the Phase 1b lead-in, enrollment may be expanded into the Phase 2 cohort expansion. Up to approximately 40 patients in each cohort (including those enrolled in the Phase 1b lead-in and those enrolled in the Phase 2 cohort expansion) will be enrolled and treated with avelumab plus chemotherapy in the initial portion of the study and, in future portions of the study, with avelumab plus chemotherapy with or without other anti-cancer immunotherapies.

In the Phase 1b lead-in portions of NSCLC Cohort A1 and UC Cohort A2, avelumab is dosed at 800 mg fixed dose every 3 weeks. Under Protocol Amendment 4, avelumab is dosed at 1200 mg fixed dose every 3 weeks in the Phase 1b lead-in portions of NSCLC Cohort A3 and in UC Cohort A4, in combination with the same standard-of-care chemotherapy doublets used in Cohort A1 and Cohort A2, respectively. For each tumor type, the study treatment combination with the highest avelumab dose determined to be safe may be advanced into Phase 2 cohort expansion.

Conditions

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Non-small Cell Lung Cancer Urothelial Cancer

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Group A Cohort A1

Non-squamous non-small cell lung cancer (NSCLC) patients treated with 800 mg avelumab plus pemetrexed/carboplatin

Group Type EXPERIMENTAL

Avelumab 800 mg in combination with pemetrexed / carboplatin

Intervention Type DRUG

Avelumab Pemetrexed Carboplatin

Group A Cohort A2

Cisplatin-eligible urothelial cancer (UC)patients treated with 800 mg avelumab plus gemcitabine/cisplatin

Group Type EXPERIMENTAL

Avelumab 800 mg in combination with gemcitabine / cisplatin.

Intervention Type DRUG

Avelumab Gemcitabine Cisplatin

Group A Cohort A3

Non-squamous non-small cell lung cancer (NSCLC) patients treated with 1200 mg avelumab plus pemetrexed/carboplatin

Group Type EXPERIMENTAL

Avelumab 1200 mg in combination with pemetrexed/carboplatin

Intervention Type DRUG

Avelumab Pemetrexed Carboplatin

Group A Cohort A4

Cisplatin-eligible urothelial cancer (UC) patients treated with 1200 mg avelumab plus gemcitabine/cisplatin

Group Type EXPERIMENTAL

Avelumab 1200 mg in combination with gemcitabine/cisplatin

Intervention Type DRUG

Avelumab Gemcitabine Cisplatin

Interventions

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Avelumab 800 mg in combination with pemetrexed / carboplatin

Avelumab Pemetrexed Carboplatin

Intervention Type DRUG

Avelumab 800 mg in combination with gemcitabine / cisplatin.

Avelumab Gemcitabine Cisplatin

Intervention Type DRUG

Avelumab 1200 mg in combination with pemetrexed/carboplatin

Avelumab Pemetrexed Carboplatin

Intervention Type DRUG

Avelumab 1200 mg in combination with gemcitabine/cisplatin

Avelumab Gemcitabine Cisplatin

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

1. Histological diagnosis of locally advanced (primary or recurrent) or metastatic solid tumor that is not amenable for treatment with curative intent as follows:

* For all groups:
* Measurable disease by RECIST v1.1 with at least 1 measurable lesion, and availability of tumor specimen 18 months or less old.
* No prior systemic treatment for unresectable locally advanced or metastatic disease for the tumor type under study. If prior systemic chemotherapy treatment was given in the adjuvant or neo-adjuvant setting or as part of radiotherapy chemotherapy treatment, disease-free interval after stop of systemic treatment must be more than 6 months for non-squamous NSCLC and more than 12 months for UC;
* Cohort A1 and Cohort A3: Non-squamous NSCLC, with no activating EGFR mutations, ALK or ROS1 translocations/rearrangements. If monotherapy pembrolizumab is available as a standard of care treatment option, patients must have a tumor proportion score (TPS) \<50% for PD L1 (via the 22C3 pharmDx or the Ventana (SP263) PD L1 IHC assay).
* Cohort A2 and Cohort A4: Transitional cell carcinoma of the urothelium including the bladder, urethra, renal pelvis, and ureter.
2. ECOG performance status 0 or 1
3. Estimated life expectancy of at least 90 days
4. Adequate bone marrow, renal, and liver function
5. Negative serum pregnancy test at screening
6. Signed and dated informed consent

Exclusion Criteria

1. Prior immunotherapy with any antibody or drug specifically targeting T cell co-stimulation or immune checkpoint pathways.
2. Patients with known symptomatic central nervous system metastases requiring steroids.
3. Diagnosis of other malignancy within 2 years prior to enrollment except adequately treated basal cell or squamous cell skin cancer, or carcinoma in situ of the bladder, breast, or cervix, or low grade (Gleason ≤6) prostate cancer
4. Use of immunosuppressive medication at the time of enrollment
5. Active or prior autoimmune disease that might deteriorate when receiving an immuno-stimulatory agent.
6. Prior organ transplantation including allogenic stem cell transplantation
7. Active infection requiring systemic therapy
8. Known history of HIV or AIDS
9. Hepatitis B virus (HBV) or hepatitis C virus (HCV) infection at screening
10. Administration of live vaccine within 4 weeks prior to study entry
11. Known prior severe hypersensitivity to the investigational products or any component in their formulations,
12. Known prior severe hypersensitivity to platinum-related compounds for all cohorts, to pemetrexed for patients enrolled in Cohort A1 and Cohort A3, and to gemcitabine for patients enrolled in Cohort A2 and Cohort A4
13. Persisting toxicity related to prior therapy (NCI CTCAE v4.03 Grade \> 1)
14. Known history of colitis, inflammatory bowel disease, pneumonitis, pulmonary fibrosis.
15. Ongoing cardiac dysrhythmias of NCI CTCAE v4.03 Grade 2 or prolongation of the QTcF interval to \>480 msec.
16. Clinically significant (ie, active) cardiovascular disease: cerebral vascular accident/stroke (\<6 months prior to enrollment), myocardial infarction (\< 6 months prior to enrollment), unstable angina, congestive heart failure, or serious cardiac arrhythmia requiring medication.
17. Major surgery ≤28 days or major radiation therapy ≤14 days prior to enrollment.
18. Participation in other studies involving investigational drug(s) within 28 days prior to study entry.
19. Concurrent treatment with a prohibited medication.
20. Other acute or chronic medical or psychiatric condition
21. Pregnant female patients; breastfeeding female patients; fertile male patients and female patients of childbearing potential who are unwilling or unable to use at least 1 highly effective method of contraception as outlined in this protocol for the duration of the study and for at least 90 days after the last dose of chemotherapy (for male and female patients) or at least 30 days after the last dose of avelumab (for female patients), whichever is longer.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Pfizer

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Pfizer CT.gov Call Center

Role: STUDY_DIRECTOR

Pfizer

Locations

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University of Arizona Cancer Center - North Campus

Tucson, Arizona, United States

Site Status

Banner-University Medical Center Tucson

Tucson, Arizona, United States

Site Status

Stony Brook Cancer Center

Stony Brook, New York, United States

Site Status

Stony Brook University

Stony Brook, New York, United States

Site Status

Montefiore Medical Center - Einstein Center for Cancer Care

The Bronx, New York, United States

Site Status

Montefiore Medical Center - Moses Division

The Bronx, New York, United States

Site Status

Duke University Medical Center/Duke Cancer Center

Durham, North Carolina, United States

Site Status

Investigational Chemotherapy Service

Durham, North Carolina, United States

Site Status

Chris O'Brien Lifehouse

Camperdown, New South Wales, Australia

Site Status

St Vincent's Hospital Sydney

Darlinghurst, New South Wales, Australia

Site Status

St Vincent's Public Hospital Sydney

Darlinghurst, New South Wales, Australia

Site Status

Western Health, Sunshine Hospital

St Albans, Victoria, Australia

Site Status

Kingston Health Sciences Centre -

Kingston, Ontario, Canada

Site Status

Fakultni nemocnice Olomouc, Klinika nuklearni mediciny

Olomouc, , Czechia

Site Status

Fakultni nemocnice Olomouc, Ustav klinicke a molekularni patologie

Olomouc, , Czechia

Site Status

Fakultni nemocnice Olomouc

Olomouc, , Czechia

Site Status

Vseobecna fakultni nemocnice v Praze

Prague, , Czechia

Site Status

Vseobecna fakultni nemocnice v Praze

Prague, , Czechia

Site Status

Vseobecna fakultni nemocnice v Praze

Prague, , Czechia

Site Status

Vseobecna fakultni nemocnice v Praze

Prague, , Czechia

Site Status

Thomayerova nemocnice

Prague, , Czechia

Site Status

Thomayerova nemocnice

Prague, , Czechia

Site Status

Centrum nuklearni mediciny s.r.o.

Prague, , Czechia

Site Status

Centrum nuklearni mediciny s.r.o.

Prague, , Czechia

Site Status

Orszagos Onkologiai Intezet "C" Belgyogyaszati - Onkologiai es Klinikai Farmakologiai Osztaly

Budapest, , Hungary

Site Status

AOU Ospedali Riuniti di Ancona Umberto I - GM Lancisi - G Salesi

Torrette Di Ancona, AN, Italy

Site Status

IRCCS Istit.Scient.Romagnolo per lo Studio e la Cura dei Tumori

Meldola, FC, Italy

Site Status

Centro di Ricerca di Fase 1, ASST Monza-Ospedale San Gerardo

Monza, MB, Italy

Site Status

Oncologia, ASST Monza-Ospedale San Gerardo

Monza, MB, Italy

Site Status

Istituto Europeo di Oncologia (IEO)

Milan, MI, Italy

Site Status

Istituto Nazionale Tumori di Napoli IRCCS Fondazione Pascale

Napoli, , Italy

Site Status

Hospital Universitario Vall d'Hebron

Barcelona, , Spain

Site Status

Hospital Clinic I Provincial

Barcelona, , Spain

Site Status

Hospital Universitario Fundacion Jimenez Diaz

Madrid, , Spain

Site Status

Hospital Universitario 12 de Octubre

Madrid, , Spain

Site Status

Fundacion Instituto Valenciano de Oncologia

Valencia, , Spain

Site Status

Royal Cornwall Hospital

Truro, Cornwall, United Kingdom

Site Status

The Platinum Medical Centre

London, England, United Kingdom

Site Status

The Wellington Hospital - South

London, England, United Kingdom

Site Status

Sarah Cannon Research Institute UK

London, England, United Kingdom

Site Status

The Harley Street Clinic

London, England, United Kingdom

Site Status

HCA Pharmacy Department

London, England, United Kingdom

Site Status

The Harley Street Clinic

London, England, United Kingdom

Site Status

The Princess Grace Hospital

London, England, United Kingdom

Site Status

Weston Park Hospital

Sheffield, South Yorkshire, United Kingdom

Site Status

Sir Bobby Robson Cancer Trials Research Centre

Newcastle upon Tyne, , United Kingdom

Site Status

Countries

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United States Australia Canada Czechia Hungary Italy Spain United Kingdom

References

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Wheatley DA, Berardi R, Climent Duran MA, Tomiak A, Greystoke AP, Joshua AM, Arkenau HT, Geczi L, Corbacho JG, Paz-Ares LG, Hussain SA, Petruzelka L, Delmonte A, Chappey C, Masters JC, Michelon E, Murphy DA, Mwewa S, Cesari R, Doger de Speville B. First-line Avelumab plus Chemotherapy in Patients with Advanced Solid Tumors: Results from the Phase Ib/II JAVELIN Chemotherapy Medley Study. Cancer Res Commun. 2024 Jun 28;4(6):1609-1619. doi: 10.1158/2767-9764.CRC-23-0459.

Reference Type DERIVED
PMID: 38669053 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Related Links

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https://pmiform.com/clinical-trial-info-request?StudyID=B9991023

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Other Identifiers

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B9991023

Identifier Type: OTHER

Identifier Source: secondary_id

2017-001741-27

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

JAVELIN CHEMOTHERAPY MEDLEY

Identifier Type: OTHER

Identifier Source: secondary_id

B9991023

Identifier Type: -

Identifier Source: org_study_id

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