Medical oncology specialty training registrar Leeds Cancer Centre York, United Kingdom
Background: 2-weekly avelumab plus axitinib is an established first-line treatment for metastatic renal cell carcinoma. In response to the Covid-19 pandemic, Leeds Cancer Centre began administering avelumab every 4 weeks. Here we evaluate outcomes for those receiving 4-weekly infusions.
Methods: We identified patients prescribed 4-weekly avelumab plus axitinib from March 2020-July 2022. Data was collected retrospectively from electronic patient records and chemotherapy prescriptions. End points included overall survival (OS), progression free survival (PFS), response rate (RR), and adverse event (AE) rates.
Results: 41 patients were included. 58.5% had a performance status of 0 and most (58.5%) had favourable risk disease as per International Metastatic RCC Data Consortium (IMDC) criteria. Median duration of follow-up was 10 months. OS at 12 months was 84.2%. PFS at 12 months was 55.8%. A complete response (CR) was observed in 2 (4.8%) patients and a partial response (PR) in 20 (48.7%) patients. 6 (14.6%) patients experienced progressive disease (PD) as their best response. 87.8% of patients had an adverse event of any grade. 21.9% experienced toxicity of grade 3 or above. 7.3% received steroids for presumed immune-related AEs. Infusion reactions were seen in 12.2%.
Conclusions: These preliminary data suggest that outcomes for patients receiving 4-weekly avelumab plus axitinib are broadly comparable to those observed using standard 2-weekly dosing. Less frequent dosing brings potential benefits to both patients and healthcare systems in terms of treatment burden and resource management. Continued exploration of optimal dose and schedule of immune checkpoint inhibitors is warranted.