Avelumab treatment in Italian patients with metastatic Merkel cell carcinoma: experience from an expanded access program

• Published in: Journal of translational medicine 2021-02, Vol.19 (1), p.70-70, Article 70
• Main Authors: Grignani, Giovanni, Chiarion Sileni, Vanna, Pinto, Carmine, Depenni, Roberta, Fazio, Nicola, Galli, Luca, Giuffrida, Dario, Carnaghi, Carlo, Ciliberto, Domenico, Corsi, Domenico C, Queirolo, Paola, Benincasa, Elena, Venturini, Filippo, Fazzi, Gennaro, Costa, Nuno, Ascierto, Paolo Antonio
• Format: Article
• Language: English
• Subjects: Adverse events; Analgesics; Antibodies, Monoclonal - therapeutic use; Antibodies, Monoclonal, Humanized; Antimitotic agents; Antineoplastic agents; Apoptosis; Avelumab; Carcinoma, Merkel Cell - drug therapy; Chemotherapy; Clinical trials; Dosage and administration; Drug therapy; Expanded access program; Fever; Humans; Immunotherapy; Italy; Medical prognosis; Melanoma; Merkel cell carcinoma; Metastases; Metastasis; Monoclonal antibodies; Oncology; Patient outcomes; Patient safety; Patients; PD-L1; Population; Regulatory approval; Response rates; Second line; Skin cancer; Skin Neoplasms - drug therapy; Targeted cancer therapy; Tumors
• ISSN: 1479-5876; 1479-5876
• DOI: 10.1186/s12967-021-02730-8

The incidence of Merkel cell carcinoma (MCC), a rare form of skin cancer with a poor prognosis, has increased in Italy in recent decades. Avelumab, an anti-programmed death ligand 1 monoclonal antibody, is approved for the treatment of metastatic MCC (mMCC) based on the results of the phase 2 JAVELIN Merkel 200 trial. The global avelumab expanded access program (EAP) was designed to provide compassionate use of avelumab prior to approval for patients with mMCC who had limited treatment options. We report findings from a subgroup of Italian patients enrolled in the avelumab EAP. Eligible patients had mMCC and progressive disease following ≥ 1 prior line of chemotherapy or were ineligible for chemotherapy or clinical trial participation. Patients received avelumab 10 mg/kg intravenously every 2 weeks. Treating physicians were provided with an initial 3-month supply of avelumab; resupply was permitted if the patient achieved a complete response, partial response, stable disease, or other clinical benefit per physician assessment. Safety and efficacy data for the EAP were reported at the treating physician's discretion. Between April 1, 2016, and September 14, 2018, 109 requests for avelumab were received from Italy, and 102 were approved. All but 1 of the approved patients had received ≥ 1 prior line of therapy. At data cutoff (March 22, 2019), 95 patients had been supplied with avelumab and response data were available for 55 patients. The objective response rate in response-evaluable patients was 29.1%, including 6 patients (10.9%) who achieved a complete response and 10 patients (18.2%) who achieved a partial response; in the total population supplied with avelumab (n = 95), the proportion who had an objective response was 16.8%. The median duration of treatment in responding patients was 9.7 months (range, 3.5-41.7 months). The most frequently reported treatment-related adverse events were infusion-related reaction (single preferred term; n = 3 [3.2%]) and pyrexia (n = 2 [2.1%]). Results from Italian patients enrolled in the avelumab EAP are consistent with the findings of the JAVELIN Merkel 200 trial and confirm the efficacy and safety of avelumab treatment in this population.