Carcinoma, Merkel Cell
Conditions
Keywords
Carcinoma, Merkel Cell, MSB0010718C, avelumab, Bavencio, anti PD-L1, JAVELIN Merkel 200
Brief summary
This is a multicenter, international, single-arm, open-label, Phase 2 trial to evaluate the efficacy and safety of avelumab in participants with metastatic Merkel cell carcinoma (MCC).
Interventions
DRUGAvelumab
Avelumab was administered at a dose of 10 milligram per kilogram (mg/kg) as 1-hour intravenous infusion once every 2 weeks until therapeutic failure, significant clinical deterioration, unacceptable toxicity, or any criterion for withdrawal from the trial or investigational medicinal product occurs.
Sponsors
EMD Serono Research & Development Institute, Inc.
Study design
Allocation
NON_RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Signed written informed consent * Age 18 years and above * Histologically proven MCC * Participants must have received at least 1 line of chemotherapy for metastatic MCC and must have progressed after the most recent line of chemotherapy * For Part B - Participants must not have received any prior systemic treatment for metastatic MCC. Prior chemotherapy treatment in the adjuvant setting (no clinically detectable disease; no metastatic disease) is allowable if the end of treatment occurred at least 6 months prior to study start) * Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 1 * Disease must be measurable with at least 1 uni-dimensional measurable lesion by RECIST Version 1.1 (including skin lesions) * Adequate hematological, hepatic and renal function (renal function considered adequate as per protocol definition) * Highly effective contraception for both male and female participants, if the risk of conception exists * Fresh Biopsy or Archival Tumor Tissue * Estimated life expectancy of more than 12 weeks
Exclusion criteria
* Participation in another interventional clinical trial within the past 30 days (participation in observational studies is permitted) * Concurrent treatment with a non permitted drug * Prior therapy with any antibody/drug targeting T-cell coregulatory proteins (immune checkpoints) such as antiprogrammed death 1 (PD-1), anti-PD-L1, or anticytotoxic T-lymphocyte antigen-4 (CTLA-4) antibody; for Part B, the Investigator must consult with the Medical Monitor and consider other co-regulatory targets such as 4-1BB * Concurrent anticancer treatment (for example, cytoreductive therapy, radiotherapy \[with the exception of palliative bone-directed radiotherapy, or radiotherapy administered on non-target superficial lesions\], immune therapy, or cytokine therapy except for erythropoietin). Radiotherapy administered to superficial lesions is not allowed if such lesions are considered target lesions in the efficacy evaluation or may influence the efficacy evaluation of the investigational agent * Major surgery for any reason, except diagnostic biopsy, within 4 weeks and/or if the participant has not fully recovered from the surgery within 4 weeks * Concurrent systemic therapy with steroids or other immunosuppressive agents, or use of any investigational drug within 28 days before the start of trial treatment. Short-term administration of systemic steroids (that is, for allergic reactions or the management of immune-related adverse events \[irAE\]) while on study is allowed. Also, participants requiring hormone replacement with corticosteroids for adrenal insufficiency are eligible if the steroids are administered only for the purpose of hormonal replacement and at doses \<= 10 mg or equivalent prednisone per day. Note: Participants receiving bisphosphonate or denosumab are eligible. * Participants with active central nervous system (CNS) metastases are excluded. Participants with a history of treated CNS metastases (by surgery or radiation therapy) are not eligible unless they have fully recovered from treatment, demonstrated no progression for at least 2 months, and do not require continued steroid therapy * Previous malignant disease (other than MCC) within the last 5 years with the exception of basal or squamous cell carcinoma of the skin and for Part A cervical carcinoma in situ or for Part B carcinoma in situ (skin, bladder, cervical, colorectal, breast or low grade prostatic intraepithelial neoplasia or Grade 1 prostate cancer) * Prior organ transplantation, including allogeneic stem-cell transplantation * Part A: Known history of testing positive for HIV or known acquired immunodeficiency syndrome (AIDS) or any positive test for hepatitis B virus or hepatitis C virus indicating acute or chronic infection. For Part B, known history of testing positive for HIV or known AIDS in consultation with the Medical Monitor or HBV or HCV infection at screening (positive HBV surface antigen or HCV RNA if anti- HCV antibody screening test positive). * Active or history of any autoimmune disease (except for participants with vitiligo) or immunodeficiencies that required treatment with systemic immunosuppressive drugs * Known severe hypersensitivity reactions to monoclonal antibodies (Grade greater than or equal to (\>=) 3 NCI CTCAE v 4.0), any history of anaphylaxis, or uncontrolled asthma (that is, 3 or more features of partially controlled asthma) * Persisting toxicity related to prior therapy Grade \> 1 NCI-CTCAE v 4.0; however, sensory neuropathy Grade \<= 2 is acceptable 14. Pregnancy or lactation * Known alcohol or drug abuse * Clinically significant (that is, active) cardiovascular disease: cerebral vascular accident / stroke (\< 6 months prior to enrollment), myocardial infarction (\< 6 months prior to enrollment), unstable angina, congestive heart failure (New York Heart Association Classification Class \>= II), or serious cardiac arrhythmia requiring medication * All other significant diseases (for example, inflammatory bowel disease), which, in the opinion of the Investigator, might impair the participant's tolerance of trial treatment * Any psychiatric condition that would prohibit the understanding or rendering of informed consent * Legal incapacity or limited legal capacity * Non oncology vaccine therapies for prevention of infectious disease (for example, seasonal flu vaccine, human papilloma virus vaccine) within 4 weeks of trial drug administration. Vaccination while on trial is also prohibited except for administration of inactivated vaccines (for example, inactivated seasonal influenza vaccine)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Part A: Number of Participants With Confirmed Best Overall Response (BOR) as Per Response Evaluation Criteria in Solid Tumors Version (RECIST) 1.1 | Up to 113 weeks | Confirmed BOR was determined according to RECIST 1.1and as adjudicated by an Independent Endpoint Review Committee(IERC) and defined as best response of any of complete response (CR), partial response(PR), stable disease(SD) and progressive disease(PD) recorded from date of randomization until disease progression/recurrence(taking smallest measurement recorded since start of treatment as reference). CR:Disappearance of all evidence of target/non-target lesions. PR:At least 30%reduction from baseline in sum of longest diameter(SLD) of all lesions. SD:Neither sufficient increase to qualify for PD nor sufficient shrinkage to qualify for PR. PD:at least a20% increase in SLD, taking as reference smallest SLD recorded from baseline/appearance of 1or more new lesions and unequivocal progression of non-target lesions. CR or PR must be confirmed by a subsequent tumor assessment preferably at next scheduled 6-weekly assessment, but no sooner than 5 weeks after initial documentation of CR or PR. |
| Part B: Durable Response Rate (DRR) | Up to 161 weeks | Durable response is defined as an objective response (confirmed complete response \[CR\] or confirmed Partial response \[PR\]) according to Response Evaluation Criteria in Solid Tumors version (RECIST) 1.1, determined by the Independent Endpoint Review Committee (IERC), with a duration of at least 6 months. The DRR was determined as the percentage of participants with an objective response in terms of CR or PR according to RECIST 1.1, as determined by the IERC, with a duration of at least 6 months. CR: Disappearance of all evidence of target and non-target lesions. PR: At least 30% reduction from baseline in the sum of the longest diameter (SLD) of all lesions. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Part A: Number of Participants With Treatment-Related (TR) Treatment-Emergent Adverse Events (TEAEs), Treatment-Related Serious TEAEs and Treatment-Related TEAEs Leading to Death | Up to 325 weeks | Related Adverse events (AE) were defined according to National Cancer Institute Common Terminology Criteria for Adverse Events Version 4.0 (NCI-CTCAE) as adverse events with relationship to study treatment reported by the investigator. A serious adverse event (SAE) was an AE that resulted in any of the following outcomes: death; life threatening; persistent/significant disability/incapacity; initial or prolonged inpatient hospitalization; congenital anomaly/birth defect or was otherwise considered medically important. Treatment-emergent are events between first dose of study drug that were absent before treatment or that worsened relative to pre-treatment state up to 30 days after last administration. TEAEs included both Serious TEAEs and non-serious TEAEs. Related TEAEs are defined as events with a relationship of missing, unknown, or yes. |
| Part A: Number of Participants With Clinically Significant Abnormalities in Laboratory Values Reported as Treatment Emergent Adverse Events (TEAEs) | Up to 325 weeks | The laboratory measurements included hematology, liver function and blood chemistry. Number of participants with clinically significant abnormalities with Grade greater than or equals to (\>=) 3 in laboratory values reported as TEAEs were reported. Clinically Significance was decided by investigator. |
| Part A: Number of Participants With Clinically Significant Abnormalities in Vital Signs Reported as Treatment Emergent Adverse Events (TEAEs) | Up to 325 weeks | Vital signs including body temperature, body weight, respiratory rate, heart rate (after 5-minute rest), and arterial blood pressure (after 5-minute rest) were evaluated. Number of participants with clinically significant abnormalities in Vital Signs reported as TEAEs. Clinically Significance was decided by investigator. |
| Part A: Number of Participants With Clinically Significant Abnormalities in Electrocardiogram (ECG) | Up to 325 weeks | A 12-lead ECG was recorded after the participant has been in a supine position breathing quietly for 5 minutes. The ECG results was used to evaluate the heart rate, atrial ventricular conduction, PR interval, QRS, QTcF and QTcB. Number of participants with clinical significant abnormalities in ECG parameter reported here. Clinically Significance was decided by investigator. |
| Part A: Interim Analysis: Overall Survival (OS) Time | Up to 87 weeks (Data reported are per pre-specified interim analysis with a data cut-off date of 3 Mar 2016) | The OS time was defined as the time from first administration of trial treatment until death. The OS time was analyzed using the Kaplan-Meier method. |
| Part A: Final Analysis: Overall Survival (OS) Time | Time from first administration of trial treatment until death (Up to 325 weeks) | The OS time was defined as the time from first administration of trial treatment until death. The OS time was analyzed using the Kaplan-Meier method. |
| Part A: Participant's Response Status According to Response Evaluation Criteria in Solid Tumors Version (RECIST) 1.1 at 6 and 12 Months | At Month 6 and 12 | The response status at 6 and 12 months after start of trial treatment according to RECIST 1.1 (as determined by the IERC) was determined. A participant was considered to be in response at the given timepoint (6 or 12 months after the start of the participant's treatment) if the participant had a documented response (PR or CR) prior to that timepoint, and neither died nor experienced disease progression according to the RECIST 1.1 nor was lost to follow-up up to the given timepoint. CR: Disappearance of all evidence of target and non-target lesions. PR: At least 30% reduction from baseline in the sum of the longest diameter (SLD) of all lesions. Percentage of participants in response and not in response according to RECIST1.1 at 6 and 12 months were reported. |
| Part A: Number of Participants With Positive Treatment Emergent Anti-Avelumab Antibodies | Up to 80 weeks | Serum samples were analyzed by a validated electrochemiluminesce immunoassay to detect the presence of anti-avelumab antibodies. Samples that screened positive were subsequently tested in a confirmatory assay. Those confirmed positive were titered for a quasi-quantitative result. Number of participants with positive treatment emergent anti-Avelumab antibodies were reported. Participants not positive prior to treatment with avelumab and with at least one positive result in the human-Antihuman Antibodies assay were characterized as treatment-emergent. |
| Part A: Serum Concentration at End of Infusion (CEOI) of Avelumab | Day 1, 43, 85, 169, 253, 337 and 421 | Serum concentration at end of infusion (CEOI) of Avelumab is reported. |
| Part A: Minimum Serum Post-dose (Ctrough) Concentration of Aveluamb | Day 15, 29, 43, 57, 71, 85, 99, 169, 211, 253, 337 and 421 | Minimum serum post-dose (Ctrough) concentration of avelumab was reported. |
| Part A: Duration of Response According to Response Evaluation Criteria in Solid Tumors Version (RECIST) 1.1 | Up to 325 weeks | The duration of response as determined from IERC tumor assessment was calculated for each participant with a confirmed response (CR or PR) as the time from first observation of response until first observation of documented disease progression or death when death occurs within 12 weeks of the last tumor assessment, whichever occurs first. CR: Disappearance of all evidence of target and non-target lesions. PR: At least 30% reduction from baseline in the sum of the longest diameter (SLD) of all lesions. Results were calculated based on Kaplan-Meier estimates. |
| Part B: Final Analysis: Overall Survival (OS) Time | Time from first administration of trial treatment until death (Up to 396 weeks) | The OS time was defined as the time from first administration of study treatment until the date of death. OS was calculated using following formula = (date of death - date of the first dose of study treatment + 1)/30.4375 (months). |
| Part B: Number of Participants With Confirmed Best Overall Response (BOR) as Per Response Evaluation Criteria in Solid Tumors Version (RECIST) 1.1 | Up to 396 weeks | Confirmed BOR was determined according to RECIST 1.1and as adjudicated by an Independent Endpoint Review Committee(IERC) and defined as best response of any of complete response (CR), partial response(PR), stable disease(SD) and progressive disease(PD) recorded from date of randomization until disease progression/recurrence(taking smallest measurement recorded since start of treatment as reference). CR:Disappearance of all evidence of target/non-target lesions. PR:At least 30%reduction from baseline in sum of longest diameter(SLD) of all lesions. SD:Neither sufficient increase to qualify for PD nor sufficient shrinkage to qualify for PR. PD:at least a20% increase in SLD, taking as reference smallest SLD recorded from baseline/appearance of 1or more new lesions and unequivocal progression of non-target lesions. CR or PR must be confirmed by a subsequent tumor assessment preferably at next scheduled 6-weekly assessment, but no sooner than 5 weeks after initial documentation of CR or PR. |
| Part B: Duration of Response According to Response Evaluation Criteria in Solid Tumors Version (RECIST) 1.1 | Up to 396 weeks | The duration of response as determined from IERC tumor assessment was calculated for each participant with a confirmed response (CR or PR) as the time from first observation of response until first observation of documented disease progression or death when death occurs within 12 weeks of the last tumor assessment, whichever occurs first. CR: Disappearance of all evidence of target and non-target lesions. PR: At least 30% reduction from baseline in the sum of the longest diameter (SLD) of all lesions. |
| Part B: Progression-Free Survival (PFS) Time According to Response Evaluation Criteria in Solid Tumors Version (RECIST) 1.1 | Up to 396 weeks | The PFS time (based on IERC tumor assessments), according to the RECIST 1.1, was defined as the time from first administration of study treatment until first observation of PD or death when death occurred within 12 weeks of the last tumor assessment or first administration of study treatment (whichever was later). PFS time (in months) was defined as: (date of PD or death - date of the first dose of study treatment + 1)/30.4375 (months). PD was defined as at least a 20% increase in the SLD, taking as reference the smallest SLD recorded from baseline or the appearance of 1 or more new lesions and unequivocal progression of non-target lesions. |
| Part B: Number of Participants With Treatment-Related (TR) Treatment-Emergent Adverse Events (TEAEs), Treatment-Related Serious TEAEs and Treatment-Related TEAEs Leading to Death | Up to 396 weeks | Related Adverse events (AE) were defined according to National Cancer Institute Common Terminology Criteria for Adverse Events Version 4.0 (NCI-CTCAE) as adverse events with relationship to study treatment reported by the investigator. A serious adverse event (SAE) was an AE that resulted in any of the following outcomes: death; life threatening; persistent/significant disability/incapacity; initial or prolonged inpatient hospitalization; congenital anomaly/birth defect or was otherwise considered medically important. Treatment-emergent are events between first dose of study drug that were absent before treatment or that worsened relative to pre-treatment state up to 30 days after last administration. TEAEs included both Serious TEAEs and non-serious TEAEs. Related TEAEs are defined as events with a relationship of missing, unknown, or yes. |
| Part B: Participant's Response Status According to RECIST 1.1 at 6 and 12 Months | At Month 6 and 12 | The response status at 6 and 12 months after start of trial treatment according to RECIST 1.1 (as determined by the IERC) was determined. A participant was considered to be in response at the given timepoint (6 or 12 months after the start of the participant's treatment) if the participant had a documented response (PR or CR) prior to that timepoint, and neither died nor experienced disease progression according to the RECIST 1.1 nor was lost to follow-up up to the given timepoint. CR: Disappearance of all evidence of target and non-target lesions. PR: At least 30% reduction from baseline in the sum of the longest diameter (SLD) of all lesions. Percentage of participants in response and not in response according to RECIST1.1 at 6 and 12 months were reported. |
| Part B: Number of Participants With Positive Treatment Emergent Anti-Avelumab Antibodies | Up to 161 weeks | Serum samples were analyzed by a validated electrochemiluminescence immunoassay to detect the presence of antidrug antibodies (ADA). Samples that screened positive were subsequently tested in a confirmatory assay. Those that confirmed positive were titered for a quasi-quantitative result. Number of participants with positive treatment emergent anti-Avelumab antibodies were reported. Participants not positive prior to treatment with avelumab and with at least one positive result in the human-Antihuman Antibodies assay were characterized as treatment-emergent. |
| Part B: Serum Concentration at End of Infusion (CEOI) of Avelumab | At Day 1, 43 and 169 | Serum concentration at end of infusion (CEOI) of Avelumab is reported. |
| Part B: Minimum Serum Post-dose (Ctrough) Concentration of Aveluamb | Day 15, Day 29, Day 43, Day 85, Day 127, Day 169, Day 253, Day 337, Day 421, Day 505, Day 589, Day 673 | Minimum serum post-dose (Ctrough) concentration of avelumab was reported. |
| Part B: Interim Analysis: Overall Survival (OS) Time | Up to 161 weeks (Data reported are per pre-specified interim analysis with a data cut-off date of 2 May 2019) | The OS time was defined as the time from first administration of study treatment until the date of death. OS was calculated using following formula = (date of death - date of the first dose of study treatment + 1)/30.4375 (months). |
| Part A: Progression-Free Survival (PFS) Time According to Response Evaluation Criteria in Solid Tumors Version (RECIST) 1.1 | Up to 325 weeks | The PFS time (based on IERC tumor assessments), according to the RECIST 1.1, was defined as the time from first administration of study treatment until first observation of PD or death when death occurred within 12 weeks of the last tumor assessment or first administration of study treatment (whichever was later). PFS time (in months) was defined as: (date of PD or death - date of the first dose of study treatment + 1)/30.4375 (months). PD was defined as at least a 20% increase in the SLD, taking as reference the smallest SLD recorded from baseline or the appearance of 1 or more new lesions and unequivocal progression of non-target lesions. |
Countries
Australia, France, Germany, Italy, Japan, Spain, United States
Participant flow
Pre-assignment details
A total of 88 participants were enrolled in Part A of the study and a total of 116 participants were enrolled in Part B of the study. Participants enrolled in Part A were not eligible for enrollment in Part B.
Participants by arm
| Arm | Count |
|---|---|
| Part A: Avelumab Participants with metastatic Merkel cell carcinoma (MCC) after failing first-line chemotherapy received Avelumab at a dose of 10 milligram per kilogram (mg/kg) as 1-hour intravenous infusion once every 2 weeks until therapeutic failure, significant clinical deterioration, unacceptable toxicity, or any criterion for withdrawal from the trial or investigational medicinal product occurs. | 88 |
| Part B: Avelumab Participants received Avelumab as first-line treatment for metastatic or distally recurrent MCC at a dose of 10 mg/kg as 1-hour intravenous infusion once every 2 weeks until therapeutic failure, significant clinical deterioration, unacceptable toxicity, or any criterion for withdrawal from the trial or investigational medicinal product occurs. | 116 |
| Total | 204 |
Baseline characteristics
| Characteristic | Part A: Avelumab | Part B: Avelumab | Total |
|---|---|---|---|
| Age, Categorical <=18 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical >=65 years | 66 Participants | 94 Participants | 160 Participants |
| Age, Categorical Between 18 and 65 years | 22 Participants | 22 Participants | 44 Participants |
| Ethnicity (NIH/OMB) Hispanic or Latino | 4 Participants | 29 Participants | 33 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 58 Participants | 75 Participants | 133 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 26 Participants | 12 Participants | 38 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 3 Participants | 3 Participants | 6 Participants |
| Race (NIH/OMB) Black or African American | 0 Participants | 2 Participants | 2 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 4 Participants | 36 Participants | 40 Participants |
| Race (NIH/OMB) White | 81 Participants | 75 Participants | 156 Participants |
| Sex: Female, Male Female | 23 Participants | 35 Participants | 58 Participants |
| Sex: Female, Male Male | 65 Participants | 81 Participants | 146 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 63 / 88 | 72 / 116 |
| other Total, other adverse events | 86 / 88 | 114 / 116 |
| serious Total, serious adverse events | 48 / 88 | 58 / 116 |
Outcome results
Primary
Part A: Number of Participants With Confirmed Best Overall Response (BOR) as Per Response Evaluation Criteria in Solid Tumors Version (RECIST) 1.1
Confirmed BOR was determined according to RECIST 1.1and as adjudicated by an Independent Endpoint Review Committee(IERC) and defined as best response of any of complete response (CR), partial response(PR), stable disease(SD) and progressive disease(PD) recorded from date of randomization until disease progression/recurrence(taking smallest measurement recorded since start of treatment as reference). CR:Disappearance of all evidence of target/non-target lesions. PR:At least 30%reduction from baseline in sum of longest diameter(SLD) of all lesions. SD:Neither sufficient increase to qualify for PD nor sufficient shrinkage to qualify for PR. PD:at least a20% increase in SLD, taking as reference smallest SLD recorded from baseline/appearance of 1or more new lesions and unequivocal progression of non-target lesions. CR or PR must be confirmed by a subsequent tumor assessment preferably at next scheduled 6-weekly assessment, but no sooner than 5 weeks after initial documentation of CR or PR.
Time frame: Up to 113 weeks
Population: Intent-to-Treat analysis set included all participants who received at least 1 dose of study treatment.
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Part A: Avelumab | Part A: Number of Participants With Confirmed Best Overall Response (BOR) as Per Response Evaluation Criteria in Solid Tumors Version (RECIST) 1.1 | Partial Response | 19 Participants |
| Part A: Avelumab | Part A: Number of Participants With Confirmed Best Overall Response (BOR) as Per Response Evaluation Criteria in Solid Tumors Version (RECIST) 1.1 | Stable Disease | 9 Participants |
| Part A: Avelumab | Part A: Number of Participants With Confirmed Best Overall Response (BOR) as Per Response Evaluation Criteria in Solid Tumors Version (RECIST) 1.1 | Non-complete Response/ Non-progressive Disease | 0 Participants |
| Part A: Avelumab | Part A: Number of Participants With Confirmed Best Overall Response (BOR) as Per Response Evaluation Criteria in Solid Tumors Version (RECIST) 1.1 | Progressive Disease | 32 Participants |
| Part A: Avelumab | Part A: Number of Participants With Confirmed Best Overall Response (BOR) as Per Response Evaluation Criteria in Solid Tumors Version (RECIST) 1.1 | Not evaluable | 18 Participants |
| Part A: Avelumab | Part A: Number of Participants With Confirmed Best Overall Response (BOR) as Per Response Evaluation Criteria in Solid Tumors Version (RECIST) 1.1 | Complete Response | 10 Participants |
Primary
Part B: Durable Response Rate (DRR)
Durable response is defined as an objective response (confirmed complete response \[CR\] or confirmed Partial response \[PR\]) according to Response Evaluation Criteria in Solid Tumors version (RECIST) 1.1, determined by the Independent Endpoint Review Committee (IERC), with a duration of at least 6 months. The DRR was determined as the percentage of participants with an objective response in terms of CR or PR according to RECIST 1.1, as determined by the IERC, with a duration of at least 6 months. CR: Disappearance of all evidence of target and non-target lesions. PR: At least 30% reduction from baseline in the sum of the longest diameter (SLD) of all lesions.
Time frame: Up to 161 weeks
Population: Full analysis set (FAS) included all participants who received at least 1 dose of study treatment.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Part A: Avelumab | Part B: Durable Response Rate (DRR) | 30.2 Percentage of participants |
Secondary
Part A: Duration of Response According to Response Evaluation Criteria in Solid Tumors Version (RECIST) 1.1
The duration of response as determined from IERC tumor assessment was calculated for each participant with a confirmed response (CR or PR) as the time from first observation of response until first observation of documented disease progression or death when death occurs within 12 weeks of the last tumor assessment, whichever occurs first. CR: Disappearance of all evidence of target and non-target lesions. PR: At least 30% reduction from baseline in the sum of the longest diameter (SLD) of all lesions. Results were calculated based on Kaplan-Meier estimates.
Time frame: Up to 325 weeks
Population: Intent-to-Treat analysis set included all participants who received at least 1 dose of study treatment. Here Number of participants analyzed signifies those participants who were evaluable for this outcome measure.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Part A: Avelumab | Part A: Duration of Response According to Response Evaluation Criteria in Solid Tumors Version (RECIST) 1.1 | 40.5 Months |
Secondary
Part A: Final Analysis: Overall Survival (OS) Time
The OS time was defined as the time from first administration of trial treatment until death. The OS time was analyzed using the Kaplan-Meier method.
Time frame: Time from first administration of trial treatment until death (Up to 325 weeks)
Population: Intent-to-Treat analysis set included all participants who received at least 1 dose of study treatment.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Part A: Avelumab | Part A: Final Analysis: Overall Survival (OS) Time | 12.6 months |
Secondary
Part A: Interim Analysis: Overall Survival (OS) Time
The OS time was defined as the time from first administration of trial treatment until death. The OS time was analyzed using the Kaplan-Meier method.
Time frame: Up to 87 weeks (Data reported are per pre-specified interim analysis with a data cut-off date of 3 Mar 2016)
Population: Intent-to-Treat analysis set included all participants who received at least 1 dose of study treatment.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Part A: Avelumab | Part A: Interim Analysis: Overall Survival (OS) Time | 11.3 Months |
Secondary
Part A: Minimum Serum Post-dose (Ctrough) Concentration of Aveluamb
Minimum serum post-dose (Ctrough) concentration of avelumab was reported.
Time frame: Day 15, 29, 43, 57, 71, 85, 99, 169, 211, 253, 337 and 421
Population: Pharmacokinetic analysis set consists of all participants who received at least 1 dose of avelumab, and provide at least 1 measurable post-dose concentration. Here Number analyzed signifies those participants who were evaluable at specified timepoints
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Part A: Avelumab | Part A: Minimum Serum Post-dose (Ctrough) Concentration of Aveluamb | Day 15 | 23.8 Micrograms per milliliter | Standard Deviation 28.4 |
| Part A: Avelumab | Part A: Minimum Serum Post-dose (Ctrough) Concentration of Aveluamb | Day 29 | 26.4 Micrograms per milliliter | Standard Deviation 13.7 |
| Part A: Avelumab | Part A: Minimum Serum Post-dose (Ctrough) Concentration of Aveluamb | Day 43 | 32.3 Micrograms per milliliter | Standard Deviation 35.8 |
| Part A: Avelumab | Part A: Minimum Serum Post-dose (Ctrough) Concentration of Aveluamb | Day 57 | 32.7 Micrograms per milliliter | Standard Deviation 18.8 |
| Part A: Avelumab | Part A: Minimum Serum Post-dose (Ctrough) Concentration of Aveluamb | Day 253 | 38.4 Micrograms per milliliter | Standard Deviation 15.7 |
| Part A: Avelumab | Part A: Minimum Serum Post-dose (Ctrough) Concentration of Aveluamb | Day 337 | 43.9 Micrograms per milliliter | Standard Deviation 23.7 |
| Part A: Avelumab | Part A: Minimum Serum Post-dose (Ctrough) Concentration of Aveluamb | Day 421 | 61.4 Micrograms per milliliter | Standard Deviation 7.79 |
| Part A: Avelumab | Part A: Minimum Serum Post-dose (Ctrough) Concentration of Aveluamb | Day 71 | 33.5 Micrograms per milliliter | Standard Deviation 21.1 |
| Part A: Avelumab | Part A: Minimum Serum Post-dose (Ctrough) Concentration of Aveluamb | Day 85 | 45.5 Micrograms per milliliter | Standard Deviation 53.6 |
| Part A: Avelumab | Part A: Minimum Serum Post-dose (Ctrough) Concentration of Aveluamb | Day 99 | 40.3 Micrograms per milliliter | Standard Deviation 24 |
| Part A: Avelumab | Part A: Minimum Serum Post-dose (Ctrough) Concentration of Aveluamb | Day 169 | 43.6 Micrograms per milliliter | Standard Deviation 19.6 |
| Part A: Avelumab | Part A: Minimum Serum Post-dose (Ctrough) Concentration of Aveluamb | Day 211 | 57.2 Micrograms per milliliter | — |
Secondary
Part A: Number of Participants With Clinically Significant Abnormalities in Electrocardiogram (ECG)
A 12-lead ECG was recorded after the participant has been in a supine position breathing quietly for 5 minutes. The ECG results was used to evaluate the heart rate, atrial ventricular conduction, PR interval, QRS, QTcF and QTcB. Number of participants with clinical significant abnormalities in ECG parameter reported here. Clinically Significance was decided by investigator.
Time frame: Up to 325 weeks
Population: Safety analysis set included all participants who received at least 1 dose of study treatment. Here Number of participants analyzed signifies those who were evaluable for this outcome measure.
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Part A: Avelumab | Part A: Number of Participants With Clinically Significant Abnormalities in Electrocardiogram (ECG) | QRS >= 120 ms | 12 Participants |
| Part A: Avelumab | Part A: Number of Participants With Clinically Significant Abnormalities in Electrocardiogram (ECG) | QTcF > 30 ms and <= 60 ms | 20 Participants |
| Part A: Avelumab | Part A: Number of Participants With Clinically Significant Abnormalities in Electrocardiogram (ECG) | QTcF > 60 ms | 1 Participants |
| Part A: Avelumab | Part A: Number of Participants With Clinically Significant Abnormalities in Electrocardiogram (ECG) | QTcB > 30 ms and <= 60 ms | 25 Participants |
| Part A: Avelumab | Part A: Number of Participants With Clinically Significant Abnormalities in Electrocardiogram (ECG) | PR interval >= 220 ms | 16 Participants |
| Part A: Avelumab | Part A: Number of Participants With Clinically Significant Abnormalities in Electrocardiogram (ECG) | QTcB > 60 ms | 2 Participants |
| Part A: Avelumab | Part A: Number of Participants With Clinically Significant Abnormalities in Electrocardiogram (ECG) | Heart rate <= 50 bpm | 3 Participants |
| Part A: Avelumab | Part A: Number of Participants With Clinically Significant Abnormalities in Electrocardiogram (ECG) | Heart rate >= 120 bpm | 2 Participants |
Secondary
Part A: Number of Participants With Clinically Significant Abnormalities in Laboratory Values Reported as Treatment Emergent Adverse Events (TEAEs)
The laboratory measurements included hematology, liver function and blood chemistry. Number of participants with clinically significant abnormalities with Grade greater than or equals to (\>=) 3 in laboratory values reported as TEAEs were reported. Clinically Significance was decided by investigator.
Time frame: Up to 325 weeks
Population: Safety analysis set included all participants who received at least 1 dose of study treatment.
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Part A: Avelumab | Part A: Number of Participants With Clinically Significant Abnormalities in Laboratory Values Reported as Treatment Emergent Adverse Events (TEAEs) | Anemia | 9 Participants |
| Part A: Avelumab | Part A: Number of Participants With Clinically Significant Abnormalities in Laboratory Values Reported as Treatment Emergent Adverse Events (TEAEs) | Lymphocyte count decreased | 18 Participants |
| Part A: Avelumab | Part A: Number of Participants With Clinically Significant Abnormalities in Laboratory Values Reported as Treatment Emergent Adverse Events (TEAEs) | Neutrophil count decreased | 1 Participants |
| Part A: Avelumab | Part A: Number of Participants With Clinically Significant Abnormalities in Laboratory Values Reported as Treatment Emergent Adverse Events (TEAEs) | Hypoalbuminemia | 2 Participants |
| Part A: Avelumab | Part A: Number of Participants With Clinically Significant Abnormalities in Laboratory Values Reported as Treatment Emergent Adverse Events (TEAEs) | Alkaline phosphatase increased | 1 Participants |
| Part A: Avelumab | Part A: Number of Participants With Clinically Significant Abnormalities in Laboratory Values Reported as Treatment Emergent Adverse Events (TEAEs) | Alanine aminotransferase increased | 3 Participants |
| Part A: Avelumab | Part A: Number of Participants With Clinically Significant Abnormalities in Laboratory Values Reported as Treatment Emergent Adverse Events (TEAEs) | Serum amylase increased | 1 Participants |
| Part A: Avelumab | Part A: Number of Participants With Clinically Significant Abnormalities in Laboratory Values Reported as Treatment Emergent Adverse Events (TEAEs) | Blood bilirubin increased | 1 Participants |
| Part A: Avelumab | Part A: Number of Participants With Clinically Significant Abnormalities in Laboratory Values Reported as Treatment Emergent Adverse Events (TEAEs) | Cholesterol high | 1 Participants |
| Part A: Avelumab | Part A: Number of Participants With Clinically Significant Abnormalities in Laboratory Values Reported as Treatment Emergent Adverse Events (TEAEs) | Creatine phosphokinase increased | 1 Participants |
| Part A: Avelumab | Part A: Number of Participants With Clinically Significant Abnormalities in Laboratory Values Reported as Treatment Emergent Adverse Events (TEAEs) | Creatinine increased | 2 Participants |
| Part A: Avelumab | Part A: Number of Participants With Clinically Significant Abnormalities in Laboratory Values Reported as Treatment Emergent Adverse Events (TEAEs) | Chronic kidney disease | 3 Participants |
| Part A: Avelumab | Part A: Number of Participants With Clinically Significant Abnormalities in Laboratory Values Reported as Treatment Emergent Adverse Events (TEAEs) | Hyperglycemia | 7 Participants |
| Part A: Avelumab | Part A: Number of Participants With Clinically Significant Abnormalities in Laboratory Values Reported as Treatment Emergent Adverse Events (TEAEs) | Hypoglycemia | 1 Participants |
| Part A: Avelumab | Part A: Number of Participants With Clinically Significant Abnormalities in Laboratory Values Reported as Treatment Emergent Adverse Events (TEAEs) | Hyperkalemia | 1 Participants |
| Part A: Avelumab | Part A: Number of Participants With Clinically Significant Abnormalities in Laboratory Values Reported as Treatment Emergent Adverse Events (TEAEs) | Hypokalemia | 2 Participants |
| Part A: Avelumab | Part A: Number of Participants With Clinically Significant Abnormalities in Laboratory Values Reported as Treatment Emergent Adverse Events (TEAEs) | Lipase increased | 4 Participants |
| Part A: Avelumab | Part A: Number of Participants With Clinically Significant Abnormalities in Laboratory Values Reported as Treatment Emergent Adverse Events (TEAEs) | Hypermagnesemia | 1 Participants |
| Part A: Avelumab | Part A: Number of Participants With Clinically Significant Abnormalities in Laboratory Values Reported as Treatment Emergent Adverse Events (TEAEs) | Hypophosphatemia | 3 Participants |
| Part A: Avelumab | Part A: Number of Participants With Clinically Significant Abnormalities in Laboratory Values Reported as Treatment Emergent Adverse Events (TEAEs) | Hyponatremia | 11 Participants |
| Part A: Avelumab | Part A: Number of Participants With Clinically Significant Abnormalities in Laboratory Values Reported as Treatment Emergent Adverse Events (TEAEs) | Platelet count decreased | 1 Participants |
| Part A: Avelumab | Part A: Number of Participants With Clinically Significant Abnormalities in Laboratory Values Reported as Treatment Emergent Adverse Events (TEAEs) | White blood cell count decreased | 1 Participants |
| Part A: Avelumab | Part A: Number of Participants With Clinically Significant Abnormalities in Laboratory Values Reported as Treatment Emergent Adverse Events (TEAEs) | Aspartate aminotransferase increased | 1 Participants |
| Part A: Avelumab | Part A: Number of Participants With Clinically Significant Abnormalities in Laboratory Values Reported as Treatment Emergent Adverse Events (TEAEs) | Gamma-glutamyltransferase increased | 6 Participants |
| Part A: Avelumab | Part A: Number of Participants With Clinically Significant Abnormalities in Laboratory Values Reported as Treatment Emergent Adverse Events (TEAEs) | Hypertriglyceridemia | 1 Participants |
Secondary
Part A: Number of Participants With Clinically Significant Abnormalities in Vital Signs Reported as Treatment Emergent Adverse Events (TEAEs)
Vital signs including body temperature, body weight, respiratory rate, heart rate (after 5-minute rest), and arterial blood pressure (after 5-minute rest) were evaluated. Number of participants with clinically significant abnormalities in Vital Signs reported as TEAEs. Clinically Significance was decided by investigator.
Time frame: Up to 325 weeks
Population: Safety analysis set included all participants who received at least 1 dose of study treatment.
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Part A: Avelumab | Part A: Number of Participants With Clinically Significant Abnormalities in Vital Signs Reported as Treatment Emergent Adverse Events (TEAEs) | Body temperature Increased | 0 Participants |
| Part A: Avelumab | Part A: Number of Participants With Clinically Significant Abnormalities in Vital Signs Reported as Treatment Emergent Adverse Events (TEAEs) | Weight Increased | 57 Participants |
| Part A: Avelumab | Part A: Number of Participants With Clinically Significant Abnormalities in Vital Signs Reported as Treatment Emergent Adverse Events (TEAEs) | Weight Decreased | 54 Participants |
| Part A: Avelumab | Part A: Number of Participants With Clinically Significant Abnormalities in Vital Signs Reported as Treatment Emergent Adverse Events (TEAEs) | Increased Heart Rate | 83 Participants |
| Part A: Avelumab | Part A: Number of Participants With Clinically Significant Abnormalities in Vital Signs Reported as Treatment Emergent Adverse Events (TEAEs) | Decreased Heart Rate | 84 Participants |
| Part A: Avelumab | Part A: Number of Participants With Clinically Significant Abnormalities in Vital Signs Reported as Treatment Emergent Adverse Events (TEAEs) | Increased Diastolic Blood Pressure | 84 Participants |
| Part A: Avelumab | Part A: Number of Participants With Clinically Significant Abnormalities in Vital Signs Reported as Treatment Emergent Adverse Events (TEAEs) | Decreased Diastolic Blood Pressure | 84 Participants |
| Part A: Avelumab | Part A: Number of Participants With Clinically Significant Abnormalities in Vital Signs Reported as Treatment Emergent Adverse Events (TEAEs) | Increased Respiratory Rate | 81 Participants |
| Part A: Avelumab | Part A: Number of Participants With Clinically Significant Abnormalities in Vital Signs Reported as Treatment Emergent Adverse Events (TEAEs) | Increased Systolic Blood Pressure | 84 Participants |
| Part A: Avelumab | Part A: Number of Participants With Clinically Significant Abnormalities in Vital Signs Reported as Treatment Emergent Adverse Events (TEAEs) | Decreased Systolic Blood Pressure | 84 Participants |
| Part A: Avelumab | Part A: Number of Participants With Clinically Significant Abnormalities in Vital Signs Reported as Treatment Emergent Adverse Events (TEAEs) | Decreased Respiratory Rate | 81 Participants |
Secondary
Part A: Number of Participants With Positive Treatment Emergent Anti-Avelumab Antibodies
Serum samples were analyzed by a validated electrochemiluminesce immunoassay to detect the presence of anti-avelumab antibodies. Samples that screened positive were subsequently tested in a confirmatory assay. Those confirmed positive were titered for a quasi-quantitative result. Number of participants with positive treatment emergent anti-Avelumab antibodies were reported. Participants not positive prior to treatment with avelumab and with at least one positive result in the human-Antihuman Antibodies assay were characterized as treatment-emergent.
Time frame: Up to 80 weeks
Population: Safety analysis set included all participants who received at least 1 dose of study treatment. Here Number of participants analyzed signifies those who were evaluable for this outcome measure.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Part A: Avelumab | Part A: Number of Participants With Positive Treatment Emergent Anti-Avelumab Antibodies | 3 Participants |
Secondary
Part A: Number of Participants With Treatment-Related (TR) Treatment-Emergent Adverse Events (TEAEs), Treatment-Related Serious TEAEs and Treatment-Related TEAEs Leading to Death
Related Adverse events (AE) were defined according to National Cancer Institute Common Terminology Criteria for Adverse Events Version 4.0 (NCI-CTCAE) as adverse events with relationship to study treatment reported by the investigator. A serious adverse event (SAE) was an AE that resulted in any of the following outcomes: death; life threatening; persistent/significant disability/incapacity; initial or prolonged inpatient hospitalization; congenital anomaly/birth defect or was otherwise considered medically important. Treatment-emergent are events between first dose of study drug that were absent before treatment or that worsened relative to pre-treatment state up to 30 days after last administration. TEAEs included both Serious TEAEs and non-serious TEAEs. Related TEAEs are defined as events with a relationship of missing, unknown, or yes.
Time frame: Up to 325 weeks
Population: Safety analysis set included all participants who received at least 1 dose of study treatment.
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Part A: Avelumab | Part A: Number of Participants With Treatment-Related (TR) Treatment-Emergent Adverse Events (TEAEs), Treatment-Related Serious TEAEs and Treatment-Related TEAEs Leading to Death | Participants with TR-TEAEs | 68 Participants |
| Part A: Avelumab | Part A: Number of Participants With Treatment-Related (TR) Treatment-Emergent Adverse Events (TEAEs), Treatment-Related Serious TEAEs and Treatment-Related TEAEs Leading to Death | Participants with TR-Serious-TEAEs | 9 Participants |
| Part A: Avelumab | Part A: Number of Participants With Treatment-Related (TR) Treatment-Emergent Adverse Events (TEAEs), Treatment-Related Serious TEAEs and Treatment-Related TEAEs Leading to Death | Participants with TR-TEAEs leading to Death | 0 Participants |
Secondary
Part A: Participant's Response Status According to Response Evaluation Criteria in Solid Tumors Version (RECIST) 1.1 at 6 and 12 Months
The response status at 6 and 12 months after start of trial treatment according to RECIST 1.1 (as determined by the IERC) was determined. A participant was considered to be in response at the given timepoint (6 or 12 months after the start of the participant's treatment) if the participant had a documented response (PR or CR) prior to that timepoint, and neither died nor experienced disease progression according to the RECIST 1.1 nor was lost to follow-up up to the given timepoint. CR: Disappearance of all evidence of target and non-target lesions. PR: At least 30% reduction from baseline in the sum of the longest diameter (SLD) of all lesions. Percentage of participants in response and not in response according to RECIST1.1 at 6 and 12 months were reported.
Time frame: At Month 6 and 12
Population: Intent-to-Treat analysis set included all participants who received at least 1 dose of study treatment.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Part A: Avelumab | Part A: Participant's Response Status According to Response Evaluation Criteria in Solid Tumors Version (RECIST) 1.1 at 6 and 12 Months | In-response at Month 12 | 20.7 Percentage of participants |
| Part A: Avelumab | Part A: Participant's Response Status According to Response Evaluation Criteria in Solid Tumors Version (RECIST) 1.1 at 6 and 12 Months | Not in-response at Month 6 | 69.3 Percentage of participants |
| Part A: Avelumab | Part A: Participant's Response Status According to Response Evaluation Criteria in Solid Tumors Version (RECIST) 1.1 at 6 and 12 Months | Not In-response at Month 12 | 79.3 Percentage of participants |
| Part A: Avelumab | Part A: Participant's Response Status According to Response Evaluation Criteria in Solid Tumors Version (RECIST) 1.1 at 6 and 12 Months | In-response at Month 6 | 30.7 Percentage of participants |
Secondary
Part A: Progression-Free Survival (PFS) Time According to Response Evaluation Criteria in Solid Tumors Version (RECIST) 1.1
The PFS time (based on IERC tumor assessments), according to the RECIST 1.1, was defined as the time from first administration of study treatment until first observation of PD or death when death occurred within 12 weeks of the last tumor assessment or first administration of study treatment (whichever was later). PFS time (in months) was defined as: (date of PD or death - date of the first dose of study treatment + 1)/30.4375 (months). PD was defined as at least a 20% increase in the SLD, taking as reference the smallest SLD recorded from baseline or the appearance of 1 or more new lesions and unequivocal progression of non-target lesions.
Time frame: Up to 325 weeks
Population: Intent-to-Treat analysis set included all participants who received at least 1 dose of study treatment.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Part A: Avelumab | Part A: Progression-Free Survival (PFS) Time According to Response Evaluation Criteria in Solid Tumors Version (RECIST) 1.1 | 2.7 Months |
Secondary
Part A: Serum Concentration at End of Infusion (CEOI) of Avelumab
Serum concentration at end of infusion (CEOI) of Avelumab is reported.
Time frame: Day 1, 43, 85, 169, 253, 337 and 421
Population: Pharmacokinetic analysis set consists of all participants who received at least 1 dose of avelumab, and provide at least 1 measurable post-dose concentration. Here Number analyzed signifies those participants who were evaluable at specified timepoints
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Part A: Avelumab | Part A: Serum Concentration at End of Infusion (CEOI) of Avelumab | Day 1 | 252 Micrograms per milliliter | Standard Deviation 129 |
| Part A: Avelumab | Part A: Serum Concentration at End of Infusion (CEOI) of Avelumab | Day 43 | 266 Micrograms per milliliter | Standard Deviation 74.2 |
| Part A: Avelumab | Part A: Serum Concentration at End of Infusion (CEOI) of Avelumab | Day 85 | 274 Micrograms per milliliter | Standard Deviation 57.7 |
| Part A: Avelumab | Part A: Serum Concentration at End of Infusion (CEOI) of Avelumab | Day 169 | 315 Micrograms per milliliter | Standard Deviation 65 |
| Part A: Avelumab | Part A: Serum Concentration at End of Infusion (CEOI) of Avelumab | Day 253 | 318 Micrograms per milliliter | Standard Deviation 70.1 |
| Part A: Avelumab | Part A: Serum Concentration at End of Infusion (CEOI) of Avelumab | Day 337 | 373 Micrograms per milliliter | Standard Deviation 48.3 |
| Part A: Avelumab | Part A: Serum Concentration at End of Infusion (CEOI) of Avelumab | Day 421 | 453 Micrograms per milliliter | Standard Deviation 71.5 |
Secondary
Part B: Duration of Response According to Response Evaluation Criteria in Solid Tumors Version (RECIST) 1.1
The duration of response as determined from IERC tumor assessment was calculated for each participant with a confirmed response (CR or PR) as the time from first observation of response until first observation of documented disease progression or death when death occurs within 12 weeks of the last tumor assessment, whichever occurs first. CR: Disappearance of all evidence of target and non-target lesions. PR: At least 30% reduction from baseline in the sum of the longest diameter (SLD) of all lesions.
Time frame: Up to 396 weeks
Population: Full Analysis Set included all participants who received at least 1 dose of study treatment. Here Number of participants analyzed signifies those participants who were evaluable for this outcome measure.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Part A: Avelumab | Part B: Duration of Response According to Response Evaluation Criteria in Solid Tumors Version (RECIST) 1.1 | 18.2 Months |
Secondary
Part B: Final Analysis: Overall Survival (OS) Time
The OS time was defined as the time from first administration of study treatment until the date of death. OS was calculated using following formula = (date of death - date of the first dose of study treatment + 1)/30.4375 (months).
Time frame: Time from first administration of trial treatment until death (Up to 396 weeks)
Population: Full Analysis Set included all participants who received at least 1 dose of study treatment.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Part A: Avelumab | Part B: Final Analysis: Overall Survival (OS) Time | 20.3 months |
Secondary
Part B: Interim Analysis: Overall Survival (OS) Time
The OS time was defined as the time from first administration of study treatment until the date of death. OS was calculated using following formula = (date of death - date of the first dose of study treatment + 1)/30.4375 (months).
Time frame: Up to 161 weeks (Data reported are per pre-specified interim analysis with a data cut-off date of 2 May 2019)
Population: Full Analysis Set included all participants who received at least 1 dose of study treatment.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Part A: Avelumab | Part B: Interim Analysis: Overall Survival (OS) Time | 20.3 Months |
Secondary
Part B: Minimum Serum Post-dose (Ctrough) Concentration of Aveluamb
Minimum serum post-dose (Ctrough) concentration of avelumab was reported.
Time frame: Day 15, Day 29, Day 43, Day 85, Day 127, Day 169, Day 253, Day 337, Day 421, Day 505, Day 589, Day 673
Population: PK Analysis Set included all participants who received at least 1 dose of avelumab, and provided at least 1 measurable post-dose concentration. Here Number analyzed signifies those participants who were evaluable at specified time-point for this outcome measure.
| Arm | Measure | Group | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|---|
| Part A: Avelumab | Part B: Minimum Serum Post-dose (Ctrough) Concentration of Aveluamb | Day 15 | 22.2 Microgram per milliliter | Geometric Coefficient of Variation 57.5 |
| Part A: Avelumab | Part B: Minimum Serum Post-dose (Ctrough) Concentration of Aveluamb | Day 29 | 27.8 Microgram per milliliter | Geometric Coefficient of Variation 80.2 |
| Part A: Avelumab | Part B: Minimum Serum Post-dose (Ctrough) Concentration of Aveluamb | Day 43 | 27.5 Microgram per milliliter | Geometric Coefficient of Variation 89.4 |
| Part A: Avelumab | Part B: Minimum Serum Post-dose (Ctrough) Concentration of Aveluamb | Day 85 | 29.4 Microgram per milliliter | Geometric Coefficient of Variation 130.4 |
| Part A: Avelumab | Part B: Minimum Serum Post-dose (Ctrough) Concentration of Aveluamb | Day 127 | 37.0 Microgram per milliliter | Geometric Coefficient of Variation 65.6 |
| Part A: Avelumab | Part B: Minimum Serum Post-dose (Ctrough) Concentration of Aveluamb | Day 169 | 45.6 Microgram per milliliter | Geometric Coefficient of Variation 60.3 |
| Part A: Avelumab | Part B: Minimum Serum Post-dose (Ctrough) Concentration of Aveluamb | Day 253 | 39.9 Microgram per milliliter | Geometric Coefficient of Variation 53 |
| Part A: Avelumab | Part B: Minimum Serum Post-dose (Ctrough) Concentration of Aveluamb | Day 337 | 39.5 Microgram per milliliter | Geometric Coefficient of Variation 37.3 |
| Part A: Avelumab | Part B: Minimum Serum Post-dose (Ctrough) Concentration of Aveluamb | Day 421 | 43.6 Microgram per milliliter | Geometric Coefficient of Variation 30.3 |
| Part A: Avelumab | Part B: Minimum Serum Post-dose (Ctrough) Concentration of Aveluamb | Day 505 | 41.8 Microgram per milliliter | Geometric Coefficient of Variation 30.4 |
| Part A: Avelumab | Part B: Minimum Serum Post-dose (Ctrough) Concentration of Aveluamb | Day 589 | 57.5 Microgram per milliliter | Geometric Coefficient of Variation 24.1 |
| Part A: Avelumab | Part B: Minimum Serum Post-dose (Ctrough) Concentration of Aveluamb | Day 673 | 44.9 Microgram per milliliter | Geometric Coefficient of Variation 21.4 |
Secondary
Part B: Number of Participants With Confirmed Best Overall Response (BOR) as Per Response Evaluation Criteria in Solid Tumors Version (RECIST) 1.1
Confirmed BOR was determined according to RECIST 1.1and as adjudicated by an Independent Endpoint Review Committee(IERC) and defined as best response of any of complete response (CR), partial response(PR), stable disease(SD) and progressive disease(PD) recorded from date of randomization until disease progression/recurrence(taking smallest measurement recorded since start of treatment as reference). CR:Disappearance of all evidence of target/non-target lesions. PR:At least 30%reduction from baseline in sum of longest diameter(SLD) of all lesions. SD:Neither sufficient increase to qualify for PD nor sufficient shrinkage to qualify for PR. PD:at least a20% increase in SLD, taking as reference smallest SLD recorded from baseline/appearance of 1or more new lesions and unequivocal progression of non-target lesions. CR or PR must be confirmed by a subsequent tumor assessment preferably at next scheduled 6-weekly assessment, but no sooner than 5 weeks after initial documentation of CR or PR.
Time frame: Up to 396 weeks
Population: Full Analysis Set included all participants who received at least 1 dose of study treatment.
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Part A: Avelumab | Part B: Number of Participants With Confirmed Best Overall Response (BOR) as Per Response Evaluation Criteria in Solid Tumors Version (RECIST) 1.1 | Complete Response | 19 Participants |
| Part A: Avelumab | Part B: Number of Participants With Confirmed Best Overall Response (BOR) as Per Response Evaluation Criteria in Solid Tumors Version (RECIST) 1.1 | Partial Response | 27 Participants |
| Part A: Avelumab | Part B: Number of Participants With Confirmed Best Overall Response (BOR) as Per Response Evaluation Criteria in Solid Tumors Version (RECIST) 1.1 | Stable Disease | 12 Participants |
| Part A: Avelumab | Part B: Number of Participants With Confirmed Best Overall Response (BOR) as Per Response Evaluation Criteria in Solid Tumors Version (RECIST) 1.1 | Non-complete Response/ Non-progressive Disease | 1 Participants |
| Part A: Avelumab | Part B: Number of Participants With Confirmed Best Overall Response (BOR) as Per Response Evaluation Criteria in Solid Tumors Version (RECIST) 1.1 | Progressive Disease | 48 Participants |
| Part A: Avelumab | Part B: Number of Participants With Confirmed Best Overall Response (BOR) as Per Response Evaluation Criteria in Solid Tumors Version (RECIST) 1.1 | Not evaluable | 9 Participants |
Secondary
Part B: Number of Participants With Positive Treatment Emergent Anti-Avelumab Antibodies
Serum samples were analyzed by a validated electrochemiluminescence immunoassay to detect the presence of antidrug antibodies (ADA). Samples that screened positive were subsequently tested in a confirmatory assay. Those that confirmed positive were titered for a quasi-quantitative result. Number of participants with positive treatment emergent anti-Avelumab antibodies were reported. Participants not positive prior to treatment with avelumab and with at least one positive result in the human-Antihuman Antibodies assay were characterized as treatment-emergent.
Time frame: Up to 161 weeks
Population: Full Analysis Set included all participants who received at least 1 dose of study treatment. Here Number of Participants analyzed signifies those participants who were evaluable for this outcome measure.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Part A: Avelumab | Part B: Number of Participants With Positive Treatment Emergent Anti-Avelumab Antibodies | 8 Participants |
Secondary
Part B: Number of Participants With Treatment-Related (TR) Treatment-Emergent Adverse Events (TEAEs), Treatment-Related Serious TEAEs and Treatment-Related TEAEs Leading to Death
Related Adverse events (AE) were defined according to National Cancer Institute Common Terminology Criteria for Adverse Events Version 4.0 (NCI-CTCAE) as adverse events with relationship to study treatment reported by the investigator. A serious adverse event (SAE) was an AE that resulted in any of the following outcomes: death; life threatening; persistent/significant disability/incapacity; initial or prolonged inpatient hospitalization; congenital anomaly/birth defect or was otherwise considered medically important. Treatment-emergent are events between first dose of study drug that were absent before treatment or that worsened relative to pre-treatment state up to 30 days after last administration. TEAEs included both Serious TEAEs and non-serious TEAEs. Related TEAEs are defined as events with a relationship of missing, unknown, or yes.
Time frame: Up to 396 weeks
Population: Full Analysis Set included all participants who received at least 1 dose of study treatment.
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Part A: Avelumab | Part B: Number of Participants With Treatment-Related (TR) Treatment-Emergent Adverse Events (TEAEs), Treatment-Related Serious TEAEs and Treatment-Related TEAEs Leading to Death | Participants with TR-Serious-TEAEs | 17 Participants |
| Part A: Avelumab | Part B: Number of Participants With Treatment-Related (TR) Treatment-Emergent Adverse Events (TEAEs), Treatment-Related Serious TEAEs and Treatment-Related TEAEs Leading to Death | Participants with TR-TEAEs leading to Death | 0 Participants |
| Part A: Avelumab | Part B: Number of Participants With Treatment-Related (TR) Treatment-Emergent Adverse Events (TEAEs), Treatment-Related Serious TEAEs and Treatment-Related TEAEs Leading to Death | Participants with TR-TEAEs | 94 Participants |
Secondary
Part B: Participant's Response Status According to RECIST 1.1 at 6 and 12 Months
The response status at 6 and 12 months after start of trial treatment according to RECIST 1.1 (as determined by the IERC) was determined. A participant was considered to be in response at the given timepoint (6 or 12 months after the start of the participant's treatment) if the participant had a documented response (PR or CR) prior to that timepoint, and neither died nor experienced disease progression according to the RECIST 1.1 nor was lost to follow-up up to the given timepoint. CR: Disappearance of all evidence of target and non-target lesions. PR: At least 30% reduction from baseline in the sum of the longest diameter (SLD) of all lesions. Percentage of participants in response and not in response according to RECIST1.1 at 6 and 12 months were reported.
Time frame: At Month 6 and 12
Population: Full Analysis Set included all participants who received at least 1 dose of study treatment.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Part A: Avelumab | Part B: Participant's Response Status According to RECIST 1.1 at 6 and 12 Months | In-response at Month 6 | 33.6 Percentage of Participants |
| Part A: Avelumab | Part B: Participant's Response Status According to RECIST 1.1 at 6 and 12 Months | In-response at Month 12 | 26.7 Percentage of Participants |
| Part A: Avelumab | Part B: Participant's Response Status According to RECIST 1.1 at 6 and 12 Months | Not in-response at Month 6 | 66.4 Percentage of Participants |
| Part A: Avelumab | Part B: Participant's Response Status According to RECIST 1.1 at 6 and 12 Months | Not in-response at Month 12 | 73.3 Percentage of Participants |
Secondary
Part B: Progression-Free Survival (PFS) Time According to Response Evaluation Criteria in Solid Tumors Version (RECIST) 1.1
The PFS time (based on IERC tumor assessments), according to the RECIST 1.1, was defined as the time from first administration of study treatment until first observation of PD or death when death occurred within 12 weeks of the last tumor assessment or first administration of study treatment (whichever was later). PFS time (in months) was defined as: (date of PD or death - date of the first dose of study treatment + 1)/30.4375 (months). PD was defined as at least a 20% increase in the SLD, taking as reference the smallest SLD recorded from baseline or the appearance of 1 or more new lesions and unequivocal progression of non-target lesions.
Time frame: Up to 396 weeks
Population: Full Analysis Set included all participants who received at least 1 dose of study treatment.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Part A: Avelumab | Part B: Progression-Free Survival (PFS) Time According to Response Evaluation Criteria in Solid Tumors Version (RECIST) 1.1 | 4.1 Months |
Secondary
Part B: Serum Concentration at End of Infusion (CEOI) of Avelumab
Serum concentration at end of infusion (CEOI) of Avelumab is reported.
Time frame: At Day 1, 43 and 169
Population: PK Analysis Set included all participants who received at least 1 dose of avelumab, and provided at least 1 measurable post-dose concentration. Here Number analyzed signifies those participants who were evaluable at specified time-point for this outcome measure.
| Arm | Measure | Group | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|---|
| Part A: Avelumab | Part B: Serum Concentration at End of Infusion (CEOI) of Avelumab | Day 1 | 237 Microgram per milliliter | Geometric Coefficient of Variation 31.1 |
| Part A: Avelumab | Part B: Serum Concentration at End of Infusion (CEOI) of Avelumab | Day 43 | 244 Microgram per milliliter | Geometric Coefficient of Variation 32.1 |
| Part A: Avelumab | Part B: Serum Concentration at End of Infusion (CEOI) of Avelumab | Day 169 | 255 Microgram per milliliter | Geometric Coefficient of Variation 27.7 |