Country for PR: United Kingdom
Contributor: PR Newswire Europe
Wednesday, March 20 2019 - 10:37
AsiaNet
Merck and Pfizer Announce Discontinuation of Phase III JAVELIN Ovarian PARP 100 Trial in Previously Untreated Advanced Ovarian Cancer
DARMSTADT, Germany and NEW YORK, March 20, 2019, /PRNewswire-AsiaNet/--

Not intended for US, Canada and UK-based media

Merck and Pfizer Inc. (NYSE: PFE) today announced the discontinuation of the 
ongoing Phase III JAVELIN Ovarian PARP 100 study evaluating the efficacy and 
safety of avelumab in combination with chemotherapy followed by maintenance 
therapy of avelumab in combination with talazoparib,* a poly (ADP-ribose) 
polymerase (PARP) inhibitor, versus an active comparator in treatment-naïve 
patients with locally advanced or metastatic ovarian cancer (Stage III or Stage 
IV). The alliance has notified health authorities and trial investigators of 
the decision to discontinue the trial.

The decision was based on several emerging factors since the trial's 
initiation, including the previously announced interim results from JAVELIN 
Ovarian PARP 100. The alliance determined that the degree of benefit observed 
with avelumab in frontline ovarian cancer in that study does not support 
continuation of the JAVELIN Ovarian PARP 100 trial in an unselected patient 
population and emphasizes the need to better understand the role of 
immunotherapy in ovarian cancer. Additional factors include the rapidly 
changing treatment landscape and the approval of a PARP inhibitor in the 
frontline maintenance setting. The decision to discontinue the JAVELIN Ovarian 
PARP 100 trial was not made for safety reasons. 

The alliance between Merck and Pfizer was the first to test an immunotherapy in 
this indication, given the significant unmet need in the treatment of ovarian 
cancer. Four out of five women with ovarian cancer are diagnosed with disease 
that has spread to the lymph nodes or to distant organs.1 Most women with 
advanced ovarian cancer ultimately die within five years due to refractory, 
resistant or recurrent disease.[2],[3] 

JAVELIN Ovarian PARP 100 (B9991030) is an open-label, international, 
multi-center, randomized study designed to evaluate the efficacy and safety of 
avelumab in combination with chemotherapy followed by maintenance therapy of 
avelumab in combination with talazoparib versus an active comparator in 
treatment-naïve patients with locally advanced or metastatic ovarian cancer 
(Stage III or Stage IV). The primary endpoint is progression-free survival 
(PFS) as determined based on blinded independent central review (BICR) 
assessment per RECIST v1.1.

The decision to discontinue the JAVELIN Ovarian PARP 100 trial does not impact 
the currently approved indications for avelumab or the remainder of the ongoing 
JAVELIN clinical development program. The program involves at least 30 clinical 
programs and more than 9,000 patients evaluated across more than 15 different 
tumor types, including breast, gastric/gastro-esophageal junction, and head and 
neck cancers, Merkel cell carcinoma, non-small cell lung cancer, and urothelial 
carcinoma.

*Avelumab and talazoparib are under clinical investigation for the treatment of 
advanced ovarian cancer and have not been demonstrated to be safe and effective 
for this use. 

About Avelumab (BAVENCIO(R))

Avelumab (BAVENCIO(R)) is a human anti-programmed death ligand-1 (PD-L1) 
antibody. Avelumab has been shown in preclinical models to engage both the 
adaptive and innate immune functions. By blocking the interaction of PD-L1 with 
PD-1 receptors, avelumab has been shown to release the suppression of the T 
cell-mediated antitumor immune response in preclinical models.4-6 Avelumab has 
also been shown to induce NK cell-mediated direct tumor cell lysis via 
antibody-dependent cell-mediated cytotoxicity (ADCC) in vitro.6-8 In November 
2014, Merck and Pfizer announced a strategic alliance to co-develop and 
co-commercialize avelumab.

BAVENCIO Approved Indications 

In September 2017, the European Commission granted conditional marketing 
authorization for BAVENCIO as a monotherapy for the treatment of adult patients 
with metastatic Merkel cell carcinoma (MCC). BAVENCIO is currently approved for 
patients with MCC in more than 45 countries globally, with the majority of 
these approvals in a broad indication that is not limited to a specific line of 
treatment. 

In the US, the FDA granted accelerated approval for BAVENCIO for the treatment 
of (i) adults and pediatric patients 12 years and older with metastatic Merkel 
cell carcinoma (mMCC) and (ii) patients with locally advanced or metastatic 
urothelial carcinoma (mUC) who have disease progression during or following 
platinum-containing chemotherapy, or have disease progression within 12 months 
of neoadjuvant or adjuvant treatment with platinum-containing chemotherapy. 
These indications are approved under accelerated approval based on tumor 
response rate and duration of response. Continued approval for these 
indications may be contingent upon verification and description of clinical 
benefit in confirmatory trials. 

BAVENCIO Safety Profile from the EU Summary of Product Characteristics (SmPC) 
The special warnings and precautions for use for BAVENCIO include 
infusion-related reactions and immune-related adverse reactions (such as 
pneumonitis, hepatitis, colitis, endocrinopathies, nephritis and renal 
dysfunction, and other adverse reactions).

The SmPC list of the most common adverse reactions in patients with solid 
tumors includes fatigue, nausea, diarrhea, decreased appetite, constipation, 
infusion-related reactions, and weight loss and vomiting. 

Indication for talazoparib (TALZENNA(R)) from the US Prescribing Information
TALZENNA is a poly (ADP-ribose) polymerase (PARP) inhibitor indicated for the 
treatment of adult patients with deleterious or suspected deleterious germline 
breast cancer susceptibility gene (BRCA)-mutated (gBRCAm) human epidermal 
growth factor receptor 2 (HER2)-negative locally advanced or metastatic breast 
cancer. Select patients for therapy based on an FDA-approved companion 
diagnostic for TALZENNA.

Important Safety Information from the TALZENNA US Prescribing Information
Myelodysplastic Syndrome/Acute Myeloid Leukemia (MDS/AML) have been reported in 
patients who received TALZENNA. Overall, MDS/AML have been reported in 2 out of 
584 (0.3%) solid tumor patients treated with TALZENNA in clinical studies. 
Myelosuppression consisting of anemia, leukopenia/neutropenia, and/or 
thrombocytopenia have been reported in patients treated with TALZENNA. Grade 
≥3 anemia, neutropenia, and thrombocytopenia were reported, respectively, 
in 39%, 21%, and 15% of patients receiving TALZENNA. Discontinuation due to 
anemia, neutropenia, and thrombocytopenia occurred, respectively, in 0.7%, 
0.3%, and 0.3% of patients.  

Monitor complete blood counts for cytopenia at baseline and monthly thereafter. 
Do not start TALZENNA until patients have adequately recovered from 
hematological toxicity caused by previous therapy. If hematological toxicity 
occurs, dose modifications (dosing interruption with or without dose reduction) 
are recommended. With respect to MDS/AML, for prolonged hematological 
toxicities, interrupt TALZENNA and monitor blood counts weekly until recovery. 
If the levels have not recovered after 4 weeks, refer the patient to a 
hematologist for further investigations. If MDS/AML is confirmed, discontinue 
TALZENNA.

TALZENNA can cause fetal harm when administered to pregnant women. Advise women 
of reproductive potential to use effective contraception during treatment and 
for at least 7 months following the last dose. A pregnancy test is recommended 
for females of reproductive potential prior to initiating TALZENNA treatment. 
Advise male patients with female partners of reproductive potential or who are 
pregnant to use effective contraception during treatment with TALZENNA and for 
at least 4 months after receiving the last dose. Based on animal studies, 
TALZENNA may impair fertility in males of reproductive potential. Advise women 
not to breastfeed while taking TALZENNA and for at least 1 month after 
receiving the last dose because of the potential for serious adverse reactions 
in nursing infants.
The most common adverse reactions (≥20%) of any grade for TALZENNA vs 
chemotherapy were fatigue (62% vs 50%), anemia (53% vs 18%), nausea (49% vs 
47%), neutropenia (35% vs 43%), headache (33% vs 22%), thrombocytopenia (27% vs 
7%), vomiting (25% vs 23%), alopecia (25% vs 28%), diarrhea (22% vs 26%), and 
decreased appetite (21% vs 22%).   

The most frequently reported Grade ≥3 adverse reactions (≥5%) for 
TALZENNA vs chemotherapy were anemia (39% vs 5%), neutropenia (21% vs 36%), and 
thrombocytopenia (15% vs 2%).    

The most common lab abnormalities (≥25%) for TALZENNA vs chemotherapy 
were decreases in hemoglobin (90% vs 77%), leukocytes (84% vs 73%), lymphocytes 
(76% vs 53%), neutrophils (68% vs 70%), platelets (55% vs 29%), and calcium 
(28% vs 16%) and increases in glucose (54% vs 51%), aspartate aminotransferase 
(37% vs 48%), alkaline phosphatase (36% vs 34%), and alanine aminotransferase 
(33% vs 37%).

Coadministration with P-gp inhibitors or BCRP inhibitors may increase TALZENNA 
exposure. If coadministering with the P-gp inhibitors amiodarone, carvedilol, 
clarithromycin, itraconazole, or verapamil is unavoidable, reduce the TALZENNA 
dose to 0.75 mg once daily. When the P-gp inhibitor is discontinued, increase 
the TALZENNA dose (after 3–5 half-lives of the P-gp inhibitor) to the dose used 
prior to the initiation of the P-gp inhibitor. When co-administering TALZENNA 
with other known P-gp inhibitors or BCRP inhibitors, monitor patients for 
potential increased adverse reactions. 
 
For patients with moderate renal impairment, the recommended dose of TALZENNA 
is 0.75 mg once daily.  No dose adjustment is required for patients with mild 
renal impairment.   TALZENNA has not been studied in patients with severe renal 
impairment or in patients requiring hemodialysis.

TALZENNA has not been studied in patients with moderate or severe hepatic 
impairment. No dose adjustment is required for patients with mild hepatic 
impairment. 

Please see full US Prescribing Information available at http://www.TALZENNA.com.
About Merck-Pfizer Alliance

Immuno-oncology is a top priority for Merck and Pfizer. The global strategic 
alliance between Merck and Pfizer enables the companies to benefit from each 
other's strengths and capabilities and further explore the therapeutic 
potential of avelumab, an anti-PD-L1 antibody initially discovered and 
developed by Merck. The immuno-oncology alliance is jointly developing and 
commercializing avelumab. The alliance is focused on developing high-priority 
international clinical programs to investigate avelumab as a monotherapy as 
well as combination regimens, and is striving to find new ways to treat cancer. 

All Merck Press Releases are distributed by e-mail at the same time they become 
available on the Merck Website. Please go to www.merckgroup.com/subscribe to 
register online, change your selection or discontinue this service. 

About Merck

Merck, a leading science and technology company, operates across healthcare, 
life science and performance materials. Around 52,000 employees work to make a 
positive difference to millions of people's lives every day by creating more 
joyful and sustainable ways to live. From advancing gene editing technologies 
and discovering unique ways to treat the most challenging diseases to enabling 
the intelligence of devices – Merck is everywhere. In 2018, Merck generated 
sales of € 14.8 billion in 66 countries. 

Scientific exploration and responsible entrepreneurship have been key to 
Merck's technological and scientific advances. This is how Merck has thrived 
since its founding in 1668. The founding family remains the majority owner of 
the publicly listed company. Merck holds the global rights to the Merck name 
and brand. The only exceptions are the United States and Canada, where the 
business sectors of Merck operate as EMD Serono in healthcare, MilliporeSigma 
in life science, and EMD Performance Materials. 

Pfizer Inc.: Working together for a healthier world(R)

At Pfizer, we apply science and our global resources to bring therapies to 
people that extend and significantly improve their lives. We strive to set the 
standard for quality, safety and value in the discovery, development and 
manufacture of health care products. Our global portfolio includes medicines 
and vaccines as well as many of the world's best-known consumer health care 
products. Every day, Pfizer colleagues work across developed and emerging 
markets to advance wellness, prevention, treatments and cures that challenge 
the most feared diseases of our time. Consistent with our responsibility as one 
of the world's premier innovative biopharmaceutical companies, we collaborate 
with health care providers, governments and local communities to support and 
expand access to reliable, affordable health care around the world. For more 
than 150 years, we have worked to make a difference for all who rely on us. We 
routinely post information that may be important to investors on our website at 
www.pfizer.com. In addition, to learn more, please visit us on www.pfizer.com 
and follow us on Twitter at @Pfizer and @Pfizer_News, LinkedIn, YouTube and 
like us on Facebook at Facebook.com/Pfizer. 

Pfizer Disclosure Notice

The information contained in this release is as of March 19, 2019. Pfizer 
assumes no obligation to update forward-looking statements contained in this 
release as the result of new information or future events or developments.
This release contains forward-looking information about avelumab (BAVENCIO), 
the Merck-Pfizer Alliance involving avelumab, and clinical development plans, 
including their potential benefits, that involves substantial risks and 
uncertainties that could cause actual results to differ materially from those 
expressed or implied by such statements. Risks and uncertainties include, among 
other things, uncertainties regarding the commercial success of avelumab; the 
uncertainties inherent in research and development, including the ability to 
meet anticipated clinical endpoints, commencement and/or completion dates for 
our clinical trials, regulatory submission dates, regulatory approval dates 
and/or launch dates, as well as the possibility of unfavorable new clinical 
data and further analyses of existing clinical data; risks associated with 
interim data; the risk that clinical trial data are subject to differing 
interpretations and assessments by regulatory authorities; whether regulatory 
authorities will be satisfied with the design of and results from our clinical 
studies; whether and when any drug applications may be filed in any 
jurisdictions for any potential indications for avelumab, combination therapies 
or talazoparib; whether and when regulatory authorities in any jurisdictions 
where applications are pending or may be submitted for avelumab, combination 
therapies or talazoparib may approve any such applications, which will depend 
on myriad factors, including making a determination as to whether the product's 
benefits outweigh its known risks and determination of the product's efficacy, 
and, if approved, whether they will be commercially successful; decisions by 
regulatory authorities impacting labeling, safety, manufacturing processes 
and/or other matters that could affect the availability or commercial potential 
of avelumab, combination therapies or talazoparib; and competitive developments.
A further description of risks and uncertainties can be found in Pfizer's 
Annual Report on Form 10-K for the fiscal year ended December 31, 2018, and in 
its subsequent reports on Form 10-Q, including in the sections thereof 
captioned "Risk Factors" and "Forward-Looking Information and Factors That May 
Affect Future Results", as well as in its subsequent reports on Form 8-K, all 
of which are filed with the U.S. Securities and Exchange Commission and 
available at www.sec.gov and www.pfizer.com.


References

1.	SEER Cancer Stat Facts: Ovarian Cancer. National Cancer Institute. Bethesda, 
MD, https://seer.cancer.gov/statfacts/html/ovary.html. Accessed March 2019. 
2.	Ledermann, JA, Raja FA, Fotopoulou C, et al. Newly diagnosed and relapsed 
epithelial ovarian carcinoma: ESMO Clinical Practice Guidelines for diagnosis, 
treatment and follow-up. Ann Oncol. 2013; 24 (Supplement 6): vi24–vi32, 
doi:10.1093/annonc/mdt333.  
3.	Ozol, RJ. Challenges for chemotherapy in ovarian cancer. Ann Oncol. 
2006;17(5):v181-187. 
4.	Dolan DE, Gupta S. PD-1 pathway inhibitors: changing the landscape of cancer 
immunotherapy. Cancer Control. 2014;21(3):231-237. 
5.	Dahan R, Sega E, Engelhardt J, et al. FcγRs modulate the anti-tumor 
activity of antibodies targeting the PD-1/PD-L1 axis. Cancer Cell. 
2015;28(3):285-295. 
6.	Boyerinas B, Jochems C, Fantini M, et al. Antibody-dependent cellular 
cytotoxicity activity of a novel anti-PD-L1 antibody avelumab (MSB0010718C) on 
human tumor cells. Cancer Immunol Res. 2015;3(10):1148-1157. 
7.	Kohrt HE, Houot R, Marabelle A, et al. Combination strategies to enhance 
antitumor ADCC. Immunotherapy. 2012;4(5):511-527. 
8.	Hamilton G, Rath B. Avelumab: combining immune checkpoint inhibition and 
antibody-dependent cytotoxicity. Expert Opin Biol Ther. 2017;17(4):515-523.
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Your Contacts 

Merck 
Media Relations:   +49-6151-72-6328, friederike.segeberg@merckgroup.com  
Investor Relations: +49-6151-72-3321, investor.relations@merckgroup.com 

Pfizer 
Media Relations:   +1-212-733-6213, jessica.m.smith@pfizer.com 
Investor Relations: +1-212-733-8160, ryan.crowe@pfizer.com 

SOURCE: Merck