Avelumab versus standard second-line chemotherapy for MSI/dMMR metastatic colorectal cancer

In patients with MSI/dMMR metastatic colorectal cancer (mCRC) first-line anti-PD-1 treatment is superior over standard treatment. The randomized phase 2 SAMCO-PRODIGE trial, in 49 centers in France, evaluated avelumab versus standard chemotherapy with or without targeted therapy as second-line treatment for MSI/dMMR mCRC after progression on oxaliplatin- or irinotecan-based first-line chemotherapy. Avelumab was superior over standard therapy for the primary endpoint of PFS (p=0.025). PFS rates after 12 and 18 months were 19% and 9% with standard treatment versus 31% and 27% with avelumab. There were no new safety signals. The authors conclude that SAMCO-PRODIGE 54 demonstrated efficacy and safety of second-line avelumab for MSI/dMMR mCRC.