Trial Outcomes & Findings for Safety and Efficacy of Avelumab in Small Intestinal Adenocarcinoma (NCT NCT03000179)

NCT ID: NCT03000179

Last Updated: 2022-04-14

Results Overview

Response rate is the proportion of patients with overall complete (CR) or partial response(PR) among patients with valuable response outcome. Overall response will consider both target and non-target lesions, as well as new lesions. Target lesions by CT/MRI: CR: Disappearance of all target lesions. PR: \>= 30% decrease in the sum of diameters of target lesions. Progressive Disease (PD): \>= 20% increase in the sum of diameters of target lesions, In addition, the sum must also demonstrate an absolute increase of at least 5 mm or appearance of new lesions. Non-target lesions: CR: Disappearance of all target lesions. Non-CR/Non-PD: Persistence of one or more non-target lesion(s) and/or maintenance of applicable tumor marker level above the normal limits. PD: progression of existing non-target lesions.

Recruitment status

TERMINATED

Study phase

PHASE2

Target enrollment

8 participants

Primary outcome timeframe

Measured every 8 weeks through study completion, an average of 1 year

Results posted on

2022-04-14

Participant Flow

Participants were enrolled onto this study at Vanderbilt University Medical Center in Nashville, TN from March 2017 to August 2019. The study closed early due to low accrual.

Participant milestones

Participant milestones
Measure
Avelumab Monotherapy
Participants receive avelumab by IV infusion following pretreatment with H1 blockers and acetaminophen once every 2 weeks. Avelumab: Avelumab through a vein once every 2 weeks
Overall Study
STARTED
8
Overall Study
COMPLETED
6
Overall Study
NOT COMPLETED
2

Reasons for withdrawal

Reasons for withdrawal
Measure
Avelumab Monotherapy
Participants receive avelumab by IV infusion following pretreatment with H1 blockers and acetaminophen once every 2 weeks. Avelumab: Avelumab through a vein once every 2 weeks
Overall Study
Lost to Follow-up
2

Baseline Characteristics

Safety and Efficacy of Avelumab in Small Intestinal Adenocarcinoma

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Avelumab Monotherapy
n=8 Participants
Participants receive avelumab by IV infusion following pretreatment with H1 blockers and acetaminophen once every 2 weeks. Avelumab: Avelumab through a vein once every 2 weeks
Age, Categorical
<=18 years
0 Participants
n=99 Participants
Age, Categorical
Between 18 and 65 years
3 Participants
n=99 Participants
Age, Categorical
>=65 years
5 Participants
n=99 Participants
Sex: Female, Male
Female
1 Participants
n=99 Participants
Sex: Female, Male
Male
7 Participants
n=99 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants
n=99 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
7 Participants
n=99 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
1 Participants
n=99 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=99 Participants
Race (NIH/OMB)
Asian
0 Participants
n=99 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=99 Participants
Race (NIH/OMB)
Black or African American
0 Participants
n=99 Participants
Race (NIH/OMB)
White
8 Participants
n=99 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=99 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=99 Participants
Region of Enrollment
United States
8 Participants
n=99 Participants

PRIMARY outcome

Timeframe: Measured every 8 weeks through study completion, an average of 1 year

Population: Patients with advanced small intestinal adenocarcinoma or ampullary tumors, efficacy-evaluable.

Response rate is the proportion of patients with overall complete (CR) or partial response(PR) among patients with valuable response outcome. Overall response will consider both target and non-target lesions, as well as new lesions. Target lesions by CT/MRI: CR: Disappearance of all target lesions. PR: \>= 30% decrease in the sum of diameters of target lesions. Progressive Disease (PD): \>= 20% increase in the sum of diameters of target lesions, In addition, the sum must also demonstrate an absolute increase of at least 5 mm or appearance of new lesions. Non-target lesions: CR: Disappearance of all target lesions. Non-CR/Non-PD: Persistence of one or more non-target lesion(s) and/or maintenance of applicable tumor marker level above the normal limits. PD: progression of existing non-target lesions.

Outcome measures

Outcome measures
Measure
Avelumab Monotherapy
n=7 Participants
Participants receive avelumab by IV infusion following pretreatment with H1 blockers and acetaminophen once every 2 weeks. Avelumab: Avelumab through a vein once every 2 weeks
Overall Response Rate as Measured Using RECIST 1.1
0.29 proportion of participants
Interval 0.08 to 0.64

PRIMARY outcome

Timeframe: On-study date to 30 days following final dose of study drug, or until the event is resolved, stabilized, or determined to be irreversible by the participating investigator if beyond 30 days.

Population: all participants

To describe the safety profile of avelumab monotherapy in patients with advanced or metastatic small intestinal adenocarcinoma

Outcome measures

Outcome measures
Measure
Avelumab Monotherapy
n=8 Participants
Participants receive avelumab by IV infusion following pretreatment with H1 blockers and acetaminophen once every 2 weeks. Avelumab: Avelumab through a vein once every 2 weeks
Number of Patients With Each Worst-Grade Toxicity
Anemia, Grade 1
2 Participants
Number of Patients With Each Worst-Grade Toxicity
Fatigue, Grade2
1 Participants
Number of Patients With Each Worst-Grade Toxicity
Infusion related reaction. Grade2
2 Participants
Number of Patients With Each Worst-Grade Toxicity
Alanine aminotransferase increased, Grade 1
1 Participants
Number of Patients With Each Worst-Grade Toxicity
Alkaline phosphatase increased, Grade 1
1 Participants
Number of Patients With Each Worst-Grade Toxicity
Anorexia, Grade 2
1 Participants
Number of Patients With Each Worst-Grade Toxicity
Blood bilirubin increased, Grade1
1 Participants
Number of Patients With Each Worst-Grade Toxicity
Diarrhea, Grade 1
1 Participants
Number of Patients With Each Worst-Grade Toxicity
Diabetic ketoacidosis, Grade 4
1 Participants
Number of Patients With Each Worst-Grade Toxicity
Back pain, Grade 1
1 Participants
Number of Patients With Each Worst-Grade Toxicity
Diverticulitis per upper GI series, Grade 2
1 Participants
Number of Patients With Each Worst-Grade Toxicity
Hypokalemia, Grade 3
1 Participants
Number of Patients With Each Worst-Grade Toxicity
Hyponatremia, Grade 3
1 Participants
Number of Patients With Each Worst-Grade Toxicity
Nausea, Grade 2
1 Participants
Number of Patients With Each Worst-Grade Toxicity
Rash maculo-papular, Grade 1
1 Participants
Number of Patients With Each Worst-Grade Toxicity
Urticaria, Grade 1
1 Participants

SECONDARY outcome

Timeframe: Every 3 months after completing treatment up to 5 years

Population: all participants

On study date until death from any cause

Outcome measures

Outcome measures
Measure
Avelumab Monotherapy
n=8 Participants
Participants receive avelumab by IV infusion following pretreatment with H1 blockers and acetaminophen once every 2 weeks. Avelumab: Avelumab through a vein once every 2 weeks
Overall Survival
6.4 months
Interval 3.8 to
Insufficient number of patients with the death event

SECONDARY outcome

Timeframe: On-study date to lesser of date of progression or date of death from any cause measured up to 3 years after treatment

Population: all participants

On-study date until disease progression or death. Progression is \>= 20% increase in the sum of diameters of target lesions or non-target lesions, or appearance of new lesions.

Outcome measures

Outcome measures
Measure
Avelumab Monotherapy
n=8 Participants
Participants receive avelumab by IV infusion following pretreatment with H1 blockers and acetaminophen once every 2 weeks. Avelumab: Avelumab through a vein once every 2 weeks
Progression Free Survival
3.4 months
Interval 3.0 to
Insufficient number of patients with progression.

SECONDARY outcome

Timeframe: Date of first partial or complete response as defined by RECIST 1.1 criteria to date of recurrence or disease progression up to 3 years

Population: Patients who had partial response.

Time from tumor response date to disease progression or death for any reason.

Outcome measures

Outcome measures
Measure
Avelumab Monotherapy
n=2 Participants
Participants receive avelumab by IV infusion following pretreatment with H1 blockers and acetaminophen once every 2 weeks. Avelumab: Avelumab through a vein once every 2 weeks
Duration of Response
10.9 months
Interval 3.0 to 18.8

Adverse Events

Avelumab Monotherapy

Serious events: 7 serious events
Other events: 8 other events
Deaths: 6 deaths

Serious adverse events

Serious adverse events
Measure
Avelumab Monotherapy
n=8 participants at risk
Participants receive avelumab by IV infusion following pretreatment with H1 blockers and acetaminophen once every 2 weeks. Avelumab: Avelumab through a vein once every 2 weeks
Endocrine disorders
Diabetic Ketoacidos
12.5%
1/8 • Number of events 1 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Vascular disorders
Thromboembolic event
12.5%
1/8 • Number of events 1 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Gastrointestinal disorders
Gastroenteritis
12.5%
1/8 • Number of events 1 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Blood and lymphatic system disorders
Anemia
12.5%
1/8 • Number of events 1 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Nervous system disorders
Ataxia
12.5%
1/8 • Number of events 1 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Gastrointestinal disorders
Nausea
12.5%
1/8 • Number of events 1 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Metabolism and nutrition disorders
Hyponatremia
12.5%
1/8 • Number of events 1 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Gastrointestinal disorders
Abdominal pain
12.5%
1/8 • Number of events 1 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Infections and infestations
Bacteremia bloodstream infection
12.5%
1/8 • Number of events 1 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Gastrointestinal disorders
Ascites
12.5%
1/8 • Number of events 1 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Gastrointestinal disorders
Colonic obstruction
12.5%
1/8 • Number of events 1 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Injury, poisoning and procedural complications
Sepsis
12.5%
1/8 • Number of events 1 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.

Other adverse events

Other adverse events
Measure
Avelumab Monotherapy
n=8 participants at risk
Participants receive avelumab by IV infusion following pretreatment with H1 blockers and acetaminophen once every 2 weeks. Avelumab: Avelumab through a vein once every 2 weeks
Gastrointestinal disorders
Abdominal pain
62.5%
5/8 • Number of events 7 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Gastrointestinal disorders
Nausea
62.5%
5/8 • Number of events 7 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Gastrointestinal disorders
Vomiting
50.0%
4/8 • Number of events 6 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Gastrointestinal disorders
Constipation
25.0%
2/8 • Number of events 2 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Gastrointestinal disorders
Diarrhea
25.0%
2/8 • Number of events 3 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Gastrointestinal disorders
Abdominal distension
12.5%
1/8 • Number of events 1 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Gastrointestinal disorders
Dyspepsia
12.5%
1/8 • Number of events 1 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Gastrointestinal disorders
Dysphagia
12.5%
1/8 • Number of events 1 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Gastrointestinal disorders
Flatulence
12.5%
1/8 • Number of events 1 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Gastrointestinal disorders
Gastrointestinal fistula
12.5%
1/8 • Number of events 1 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Gastrointestinal disorders
Small intestinal mucositis
12.5%
1/8 • Number of events 1 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Blood and lymphatic system disorders
Anemia
87.5%
7/8 • Number of events 20 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Investigations
Lymphocyte count decreased
50.0%
4/8 • Number of events 8 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Investigations
Alkaline phosphatase increased
37.5%
3/8 • Number of events 8 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Investigations
Weight loss
37.5%
3/8 • Number of events 5 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Investigations
Activated partial thromboplastin time prolonged
25.0%
2/8 • Number of events 3 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Investigations
Alanine aminotransferase increased
25.0%
2/8 • Number of events 2 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Investigations
Blood bilirubin increased
25.0%
2/8 • Number of events 2 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Investigations
Aspartate aminotransferase increased
12.5%
1/8 • Number of events 2 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Investigations
INR increased
12.5%
1/8 • Number of events 1 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Investigations
White blood cell decreased
12.5%
1/8 • Number of events 1 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
General disorders
Fatigue
50.0%
4/8 • Number of events 5 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
General disorders
Fever
25.0%
2/8 • Number of events 4 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
General disorders
Chills
12.5%
1/8 • Number of events 1 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
General disorders
Limb edema
12.5%
1/8 • Number of events 1 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
General disorders
Facial pain
12.5%
1/8 • Number of events 1 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
General disorders
Gait disturbance
12.5%
1/8 • Number of events 1 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
General disorders
Infusion related reaction
12.5%
1/8 • Number of events 1 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Metabolism and nutrition disorders
Hypoalbuminemia
37.5%
3/8 • Number of events 8 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Metabolism and nutrition disorders
Hyponatremia
37.5%
3/8 • Number of events 5 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Metabolism and nutrition disorders
Hypercalcemia
25.0%
2/8 • Number of events 2 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Investigations
Hypocalcemia
25.0%
2/8 • Number of events 7 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Metabolism and nutrition disorders
Hypokalemia
25.0%
2/8 • Number of events 2 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Metabolism and nutrition disorders
Anorexia
12.5%
1/8 • Number of events 2 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Metabolism and nutrition disorders
Dehydration
12.5%
1/8 • Number of events 1 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Metabolism and nutrition disorders
Hyperkalemia
12.5%
1/8 • Number of events 2 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Metabolism and nutrition disorders
Hyperuricemia
12.5%
1/8 • Number of events 1 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Metabolism and nutrition disorders
Hypomagnesemia
12.5%
1/8 • Number of events 1 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Infections and infestations
Mucosal infection
25.0%
2/8 • Number of events 2 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Infections and infestations
Lung infection
12.5%
1/8 • Number of events 1 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Infections and infestations
Small intestine infection
12.5%
1/8 • Number of events 1 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Infections and infestations
Upper respiratory infection
12.5%
1/8 • Number of events 1 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Nervous system disorders
Headache
25.0%
2/8 • Number of events 3 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Nervous system disorders
Syncope
25.0%
2/8 • Number of events 2 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Nervous system disorders
Dizziness
12.5%
1/8 • Number of events 1 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Nervous system disorders
memory impairement
12.5%
1/8 • Number of events 1 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Nervous system disorders
Presyncope
12.5%
1/8 • Number of events 1 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Respiratory, thoracic and mediastinal disorders
Dyspnea
37.5%
3/8 • Number of events 3 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Respiratory, thoracic and mediastinal disorders
Allergic rhinitis
25.0%
2/8 • Number of events 2 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Respiratory, thoracic and mediastinal disorders
Couph
12.5%
1/8 • Number of events 1 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Vascular disorders
Hypertension
25.0%
2/8 • Number of events 3 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Nervous system disorders
Thromboembolic event
25.0%
2/8 • Number of events 2 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Vascular disorders
Phlebitis
12.5%
1/8 • Number of events 1 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Musculoskeletal and connective tissue disorders
Neck pain
25.0%
2/8 • Number of events 4 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Musculoskeletal and connective tissue disorders
Back pain
12.5%
1/8 • Number of events 2 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Musculoskeletal and connective tissue disorders
Generalized muscle weaknes
12.5%
1/8 • Number of events 1 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Musculoskeletal and connective tissue disorders
Myalgia
12.5%
1/8 • Number of events 1 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Musculoskeletal and connective tissue disorders
Extremity pain
12.5%
1/8 • Number of events 1 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Psychiatric disorders
Anxiety
12.5%
1/8 • Number of events 1 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Psychiatric disorders
Confusion
12.5%
1/8 • Number of events 1 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Psychiatric disorders
Depression
12.5%
1/8 • Number of events 1 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Psychiatric disorders
Insomnia
12.5%
1/8 • Number of events 2 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Psychiatric disorders
Psychosis
12.5%
1/8 • Number of events 2 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Psychiatric disorders
Restlessness
12.5%
1/8 • Number of events 1 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Renal and urinary disorders
Proteinuria
37.5%
3/8 • Number of events 3 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Renal and urinary disorders
Hematuria
12.5%
1/8 • Number of events 1 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Skin and subcutaneous tissue disorders
Dry skin
12.5%
1/8 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Skin and subcutaneous tissue disorders
Photosensitivity
12.5%
1/8 • Number of events 1 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Skin and subcutaneous tissue disorders
Pruritus
12.5%
1/8 • Number of events 1 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Skin and subcutaneous tissue disorders
Rash maculo-papular
12.5%
1/8 • Number of events 1 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Skin and subcutaneous tissue disorders
Urticaria
12.5%
1/8 • Number of events 1 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Cardiac disorders
Chest pain
12.5%
1/8 • Number of events 2 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Cardiac disorders
Sinus tachycardia
12.5%
1/8 • Number of events 1 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Injury, poisoning and procedural complications
Fall
25.0%
2/8 • Number of events 2 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Ear and labyrinth disorders
Vertigo
12.5%
1/8 • Number of events 1 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Endocrine disorders
Adrenal insufficiency
12.5%
1/8 • Number of events 1 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.
Eye disorders
Blurred vision
12.5%
1/8 • Number of events 1 • From study entry to up to 28 days from the last dose of avelumab up to approximately 1 year.

Additional Information

Teresa Melton

Vanderbilt-Ingram Cancer Center

Phone: 615-936-7423

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place