Avelumab - 线维持治疗晚期尿路上皮癌:马来西亚早期准入项目的真实世界结果
17 November 2025
Fuad Bin Ismail, Mohamed Ibrahim Abdul Wahid, Muthukkumaran Thiagarajan, Ai Lian Tan, Nellie Lay Chin Cheah, Kai Seng Lam, Doris Sze Ying Chow, Soo Fan Ang, Michelle Ng, Hannah Loke, John Seng Hooi Low
摘要
Aim
Avelumab first-line (1L) maintenance was approved for treatment of advanced urothelial carcinoma (UC) based on results from the JAVELIN Bladder 100 Phase 3 trial. We report real-world data from an early access program (EAP) for avelumab 1L maintenance treatment in Malaysia.
Methods
Data from patients with locally advanced or metastatic UC who received ≥ 1 dose of avelumab 1L maintenance treatment between September 2021 and January 2023 were obtained retrospectively. Patient and treatment characteristics, best response to treatment, and safety were assessed.
Results
Data were provided from 13 patients treated at 9 hospitals in Malaysia. Seven patients (53.8%) were female, and ECOG performance status prior to 1L chemotherapy was 0-1 in 11 patients (84.6%) and 2 in 2 patients (15.4%). Chemotherapy included cisplatin in 6 patients (46.2%) and carboplatin in 7 patients (53.8%), and the best response was complete response in 1 patient (7.7%), partial response in 7 patients (53.8%), and stable disease in 5 patients (38.5%). The median duration of avelumab treatment was 9 months, with treatment ongoing in 4 patients (30.8%) at last follow-up. The objective response rate was 30.8% and an additional 5 patients (38.5%) had stable disease as the best response. Median PFS was 10.4 months. Reasons for discontinuation were disease progression in 8 patients (61.5%) and patient withdrawal in 1 patient (7.7%). Treatment-related adverse events occurred in 3 patients (23.1%) and were grade 2 in 1 patient (7.7%) and grade 1 in 2 (15.4%).
Conclusions
Data from this small EAP population support the use of avelumab 1L maintenance treatment in patients with advanced UC in Malaysia.
参考资料
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引用
F. B. Ismail, M. I. A. Wahid, M. Thiagarajan, et al. “ Avelumab First-Line Maintenance for Advanced Urothelial Carcinoma: Real-World Results From an Early Access Program in Malaysia.” Asia-Pacific Journal of Clinical Oncology (2025): . https://doi.org/10.1111/ajco.70042


