Multicenter phase 2 trial of avelumab versus standard second-line chemotherapy for metastatic colorectal cancer with microsatellite instability

The randomized phase 2 SAMCO-PRODIGE 54 trial, at 49 centers in France, compared second-line avelumab (anti-PD-L1) versus standard second-line therapy among 122 patients with deficient mismatch repair and/or microsatellite instability metastatic colorectal cancer (dMMR/MSI mCRC) and progression on first-line therapy. The study found significantly better progression-free survival and disease control duration with avelumab compared with standard therapy. In addition, avelumab had a favorable safety profile. The authors conclude that for patients with dMMR/MSI mCRC not treated with pembrolizumab in the first-line setting, immune checkpoint inhibitors may be an option in the second-line setting, with better efficacy and tolerability than the current standard of care (visual abstract).