{"id":375893,"date":"2024-02-29T10:04:51","date_gmt":"2024-02-29T09:04:51","guid":{"rendered":"https:\/\/medizinonline.com\/successful-treatment-with-immunotherapy\/"},"modified":"2024-02-29T10:11:32","modified_gmt":"2024-02-29T09:11:32","slug":"successful-treatment-with-immunotherapy","status":"publish","type":"post","link":"https:\/\/medizinonline.com\/en\/successful-treatment-with-immunotherapy\/","title":{"rendered":"Successful treatment with immunotherapy"},"content":{"rendered":"\n

Chemotherapy (ChT) has always been the standard of care for the treatment of metastatic Merkel cell carcinoma (mMCC), but response rates are often not sustained [1, 2]. Bavencio\u00ae (avelumab)<\/strong> is the first and only anti-PD-L1 immunotherapy approved in Switzerland for patients with mMCC and is convincing in both the first (1L) and subsequent lines (2L+) with a sustained response and significant survival benefit for patients [2-6]. Current data also confirm its effectiveness in a real clinical context [7-9].<\/strong><\/p>\n\n\n\n

Merkel cell carcinoma (MCC) is a rare disease, but its incidence is increasing [10, 11]. Patients with metastatic disease in particular have a poor prognosis and less than 18% survive for more than 5 years [1, 12]. Bavencio\u00ae (avelumab) is an effective immunotherapy in this setting as an alternative to ChT [3, 4]. This article gives you an overview of the most important study results on avelumab in 1L and 2L+ and also summarizes new real-world data presented at the ESMO Congress in October 2023 [1, 2, 5-9].<\/p>\n\n

Sustained response and survival benefit with avelumab <\/h5>\n\n

The 1L efficacy of avelumab was tested in a cohort of the phase 2 JAVELIN Merkel 200 study, which included 116 patients with previously untreated mMCC [6]. After a median follow-up of 54.3 months (range: 48.0 – 69.7), the median overall survival (mOS) was 20.3 months (95% CI: 12.4 – 42.0), with a 4-year OS rate of 38.0% (95% CI: 29.0 – 47.0) [6]. The efficacy of avelumab in 2L+ was tested in 88 patients whose disease had progressed after one or more previous lines of ChT [1, 5]. After a median follow-up of 65.1 months (range: 60.8 – 74.1), the mOS was 12.6 months (95% CI: 7.5 – 17.1) with a 5-year OS rate of 26% (95% CI: 17 – 36) [5]. In addition, avelumab showed a low rate of higher grade treatment-related adverse events (TRAEs) and there were no treatment-related deaths in either 1L or 2L+ [2, 5]. <\/p>\n\n

Real-world data confirm efficacy in 1L and 2L+<\/h5>\n\n

In a prospective German registry study, 100 patients with non-resectable stage III or IV mMCC in 1L were treated with avelumab [7]. After a follow-up of 28.8 months (95% CI: 20.5 – 32.5), the mOS was not reached in either group. The mPFS was 15.6 months (95% CI: 5.6 – NE) and 7.3 months (95% CI: 3.0 – 13.7) for stage III and stage IV mMCC, respectively [7]. In another registry study from England, the mOS of patients with stage III or IV mMCC treated with avelumab or another 1L treatment was compared [8]. With an mOS of 37.8 (95% CI: 12.9 – NE) vs. 13.0 (95% CI: 8.3 – 19.6) months for stage III and 19.9 (95% CI: 5.0 – NE) vs. 7.2 (95% CI: 5.9 – 9.1) months for stage IV, treatment with avelumab proved to be superior compared to other 1L therapies (Fig. 1) [8]. Most recently, a retrospective study from France included 180 patients with mMCC who were treated with avelumab in 2L+. After a median follow-up of 13.1 months, an mOS of 14.6 months (95% CI: 9.9 – 21.3) was recorded from the start of treatment [9]. <\/p>\n\n

Conclusion<\/h5>\n\n

Overall, both 1L and 2L+ treatment with avelumab offer significant survival benefits for mMCC patients [5, 6]. At the same time, low rates of higher-grade TRAE were observed [2, 5]. Real-world data from several cohorts confirm the survival benefit of avelumab in 1L and 2L+ and thus confirm the clinical results from the JAVELIN Merkel 200 study [2, 5, 7-9]. <\/p>\n\n

\"\"<\/a><\/figure>\n\n

Figure 1)<\/strong> Overall survival (OS) of patients with stage III or IV mMCC from the start of 1L therapy with avelumab (dark blue) or other 1L therapies (95.5% of which ChT, turquoise). Adapted from Knott et al. 2023 [8].<\/p>\n\n

Abbreviations<\/h5>\n\n

ESMO = European Society for Medical Oncology; CI = confidence interval; PD-L1 = programmed death-ligand 1 <\/p>\n\n

The BAVENCIO\u00ae brief technical information.<\/p>\n\n

CH-AVE-00074 01\/2024<\/p>\n\n

With the financial support of Merck (Schweiz) AG.<\/p>\n\n

Literature<\/p>\n\n

1 D’Angelo, S.P., et al, Avelumab in patients with previously treated metastatic Merkel cell carcinoma: long-term data and biomarker analyses from the single-arm phase 2 JAVELIN Merkel 200 trial.<\/em> J Immunother Cancer, 2020. 8<\/strong>(1).2 D’Angelo, S.P., et al, First-line avelumab in a cohort of 116 patients with metastatic Merkel cell carcinoma (JAVELIN Merkel 200): primary and biomarker analyses of a phase II study<\/em>. J Immunother Cancer, 2021. 9<\/strong>(7).3. information for healthcare professionals BAVENCIO\u00ae (avelumab) <\/em>. \n www.swissmedicinfo.ch<\/em>\n<\/a>, current status.<\/em>4 Becker, J.C., et al, S2k guideline – Merkel cell carcinoma – Update 2022<\/em>, J Dtsch Dermatol Ges, 2023. 21<\/strong>(3): p. 305-317.5 D’Angelo, S.P., et al, Avelumab in patients with previously treated metastatic Merkel cell carcinoma (JAVELIN Merkel 200): updated overall survival data after ><\/em> 5 years of follow-up.<\/em> ESMO Open, 2021. 6<\/strong>(6): p. 100290.6 D’Angelo, S.P., et al, 604 First-line avelumab treatment in patients with metastatic Merkel cell carcinoma: 4-year follow-up from the JAVELIN Merkel 200 trial<\/em>. Journal for ImmunoTherapy of Cancer, 2022. 10<\/strong>(Suppl 2): p. A633-A633.7 Becker JC, et al. Clinical characteristics and survival of patients with advanced Merkel cell carcinoma (MCC) treated with avelumab: Analysis of a prospective German MCC registry (MCC TRIM). Presentation #1145P. Presented at ESMO Congress October 20-24, 2023.<\/em>8 Knott C, et al. First-line treatment (tx) patterns and overall survival (OS) of patients (pts) with advanced Merkel cell carcinoma (aMCC) in England from 2013-2022: Results of a nationwide observational cohort study. Presentation #1147P. Presented at ESMO Congress October 20-24, 2023.<\/em>9 Blom A, et al. Avelumab as second-line or later (2L+) treatment (tx) in patients (pts) with metastatic Merkel cell carcinoma (mMCC): Real-world tx patterns in France. Presentation #1148P. Presented at ESMO Congress October 20-24, 2023.<\/em>10 Paulson, K.G., et al, Merkel cell carcinoma: Current US incidence and projected increases based on changing demographics<\/em>. J Am Acad Dermatol, 2018. 78<\/strong>(3): p. 457-463.e2.11 Villani, A., et al, Merkel Cell Carcinoma: Therapeutic Update and Emerging Therapies<\/em>. Dermatol Ther (Heidelberg), 2019. 9<\/strong>(2): p. 209-222.12 Lemos, B.D., et al, Pathologic nodal evaluation improves prognostic accuracy in Merkel cell carcinoma: analysis of 5823 cases as the basis of the first consensus staging system<\/em>. J Am Acad Dermatol, 2010. 63<\/strong>(5): p. 751-61.<\/p>\n\n

The references are available on request.<\/p>\n\n

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Chemotherapy (ChT) has always been the standard of care for the treatment of metastatic Merkel cell carcinoma (mMCC), but response rates are often not sustained [1, 2]. Bavencio\u00ae (avelumab) is…<\/p>\n","protected":false},"author":14,"featured_media":375907,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"pmpro_default_level":"","cat_1_feature_home_top":false,"cat_2_editor_pick":false,"csco_eyebrow_text":"Metastatic Merkel cell carcinoma","footnotes":""},"category":[11513,11370,11323,11548],"tags":[40894,36040],"powerkit_post_featured":[],"class_list":["post-375893","post","type-post","status-publish","format-standard","has-post-thumbnail","category-congress-reports","category-oncology","category-partner-content-en","category-rx-en","tag-congress","tag-oncology","pmpro-has-access"],"acf":[],"publishpress_future_action":{"enabled":false,"date":"2026-05-18 01:25:22","action":"change-status","newStatus":"draft","terms":[],"taxonomy":"category","extraData":[]},"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"wpml_current_locale":"en_US","wpml_translations":{"fr_FR":{"locale":"fr_FR","id":375888,"slug":"un-traitement-efficace-grace-a-limmunotherapie","post_title":"Un traitement efficace gr\u00e2ce \u00e0 l\u2019immunoth\u00e9rapie","href":"https:\/\/medizinonline.com\/fr\/un-traitement-efficace-grace-a-limmunotherapie\/"},"it_IT":{"locale":"it_IT","id":375895,"slug":"trattamento-di-successo-con-limmunoterapia","post_title":"Trattamento di successo con l'immunoterapia","href":"https:\/\/medizinonline.com\/it\/trattamento-di-successo-con-limmunoterapia\/"},"pt_PT":{"locale":"pt_PT","id":375892,"slug":"tratamento-bem-sucedido-com-imunoterapia","post_title":"Tratamento bem sucedido com imunoterapia","href":"https:\/\/medizinonline.com\/pt-pt\/tratamento-bem-sucedido-com-imunoterapia\/"},"es_ES":{"locale":"es_ES","id":375894,"slug":"exito-del-tratamiento-con-inmunoterapia","post_title":"\u00c9xito del tratamiento con inmunoterapia","href":"https:\/\/medizinonline.com\/es\/exito-del-tratamiento-con-inmunoterapia\/"}},"_links":{"self":[{"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/posts\/375893","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/users\/14"}],"replies":[{"embeddable":true,"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/comments?post=375893"}],"version-history":[{"count":1,"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/posts\/375893\/revisions"}],"predecessor-version":[{"id":375901,"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/posts\/375893\/revisions\/375901"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/media\/375907"}],"wp:attachment":[{"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/media?parent=375893"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/category?post=375893"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/tags?post=375893"},{"taxonomy":"powerkit_post_featured","embeddable":true,"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/powerkit_post_featured?post=375893"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}