JAVELIN Lung 200: Avelumab Versus Docetaxel in Advanced Lung Cancer
Posted: Monday, November 19, 2018
According to the JAVELIN Lung 200 trial, the anti–PD-L1 antibody body avelumab did not offer a survival benefit over docetaxel in patients with PD-L1–positive advanced non–small cell lung cancer (NSCLC). However, avelumab was associated with improved overall survival in a subset of patients—those with at least 50% PD-L1 expression—and it was also associated with fewer adverse events. Fabrice Barlesi, MD, PhD, of the University of Aix Marseille, and colleagues, published these study results in The Lancet Oncology.
In this phase III, multicenter, open-label study, 792 patients with metastatic or advanced NSCLC that progressed after platinum doublet therapy were randomly assigned to receive avelumab or docetaxel. The primary analysis focused on the 264 patients treated with avelumab and the 265 patients treated with docetaxel who had PD-L1–positive tumors (≥ 1% expression). The median follow-up for survival in this PD-L1–positive group was 18.3 months.
The median overall survival for avelumab-treated patients with PD-L1–positive disease was 11.4 months compared with 10.3 months in docetaxel-treated patients with PD-L1–positive disease. In a prespecified exploratory analysis, avelumab was associated with improved overall survival among the 168 patients treated with avelumab and the 147 patients treated with docetaxel with PD-L1 expression of at least 50% (13.6 vs. 9.2 months) as well as among the 120 patients and 106 patients who had PD-L1 expression of at least 80% (17.1 vs. 9.3 months).
Of note, avelumab-associated adverse events were fewer and of a lower grade than docetaxel-associated adverse events. Treatment-related deaths occurred in 1% of patients in the avelumab group, compared with 4% of patients in the docetaxel group.