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by Dr. C.H. Weaver M.D. updated 2/2022

Bavencio (avelumab), immunotherapy is a programmed cell death ligand–1 (PD L1) inhibitor that has been approved for treatment of patients with locally advanced or metastatic urothelial carcinoma.

About Urothelial Cancer

Bladder cancer is the most common type of urothelial carcinoma, and up to half of all people with the advanced form of the disease are unable to receive cisplatin chemotherapy as an initial treatment and therefore have a high unmet medical need. Urothelial carcinoma also includes cancers of the urethra, ureters and renal pelvis. According to the American Cancer Society (ACS), it is estimated that more than 80,000 Americans will be diagnosed in 2021 with bladder cancer, which is the most common type of urothelial cancer.

Discuss this article with other patients and caregivers facing a diagnosis of bladder cancer.

Bladder Cancer CancerConnect

About Bavencio

Bavencio targets the programmed cell death-ligand PD-1/PD-L1 pathway with potential immune checkpoint inhibitory and anti-cancer activity. When Bavencio binds to PD-L1 it blocks the interaction of PD-L1 with its receptor protein 1 (PD-1). This inhibits the activation of PD-1 and restores immune function through the activation of cytotoxic T lymphocytes targeted to PD-L1-over expressing cancer cells.

In the JAVELIN Bladder cancer clinical trial 700 patients with unresectable locally advanced or metastatic urothelial carcinoma and no disease progression following chemotherapy (with either gemcitabine combined with cisplatin or carboplatin) were treated with maintenance Bavencio and best supportive care or best supportive care alone and directly compared. 

Bavencio treatment improved overall survival from 15 months to 24 months on average. Just over half the patients had cancers that were positive for programmed death-ligand 1 (PD-L1) and these patients appeared to have even better survival.

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Long Term Follow Up Confirms Benefit

At 38 months median follow-up, patients who received first-line maintenance Bavencio showed consistent overall survival benefit.

  • Median survival was improved from 15 to 24 months.
  • 44% of Bavencio treated patients survived greater than 30 months compared to 33% of those not receiving Bavencio.
  • In the population of patients with PD-L1+ tumors more than half of patients who received Bavencio were alive at 30 months

More About Bavencio

The most common side effects reported with Bavaencio in bladder cancer have been urinary tract infections, anemia, blood in the urine, fatigue, and back pain. Bavencio joins three similar immunotherapies already approved for the treatment of bladder cancer, expanding patients options for treatment for the first time in many years.

Genitourinary Cancer Newsletter 490 GU

References:

  1. Avelumab (BAVENCIO)
  2. Maintenance avelumab + best supportive care (BSC) versus BSC alone after platinum-based first-line (1L) chemotherapy in advanced urothelial carcinoma (UC): JAVELIN Bladder 100 phase III interim analysis.
  3. Powles T, Park SH, Voog E, et al. Avelumab first-line (1L) maintenance for advanced urothelial carcinoma (UC): long-term follow up results from the JAVELIN Bladder 100 trial. Presented at ASCO GU 2022.