A Study Of Avelumab In Combination With Other Cancer Immunotherapies In Advanced Malignancies (JAVELIN Medley)
Study Details
Study Description
Brief Summary
This is a Phase 1b/2 dose-optimization study to evaluate safety, pharmacokinetics, pharmacodynamics, and preliminary antitumor activity of avelumab (MSB0010718C) in combination with other cancer immunotherapies in patients with locally advanced or metastatic solid tumors. The primary purpose is to assess the safety and early signs of efficacy of various avelumab combinations with other cancer immunotherapies, optimizing dosing regimens as appropriate, in a limited series of indications.
Condition or Disease | Intervention/Treatment | Phase |
---|---|---|
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Phase 1/Phase 2 |
Detailed Description
This is a Phase 1b/2, open-label, multi-center, multiple-dose, safety, clinical activity, PK, and PD study of avelumab in combination with other immune modulators in adult patients with locally advanced or metastatic solid tumors (eg, non-small cell lung cancer (NSCLC), melanoma, squamous cell carcinoma of the head and neck (SCCHN), triple-negative breast cancer (TNBC), gastric cancer, platinum resistant ovarian cancer, bladder cancer, small cell lung cancer (SCLC) and progressing tenosynovial giant cell tumor/pigmented villonodular synovitis (TGCT/PVNS) . In Phase 1b, this includes patients whose disease has progressed on standard of care therapy or for whom no standard therapy is available. In Phase 2, enrollment criteria regarding prior treatment(s) received varies by tumor type. Incorporation of the other immune modulators into this study is based on preclinical and clinical data supportive of single-agent tolerability and potential clinical benefit, as well as non-clinical data suggesting safety, tolerability and clinical benefit of the agent(s) in combination with avelumab. Combinations of avelumab plus other immune modulator(s) to be evaluated are as follows:
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Combination A: avelumab plus utomilumab (4-1BB agonist mAb)
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Combination B: avelumab plus PF-04518600 (OX40 agonist mAb)
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Combination C: avelumab plus PD 0360324 (M-CSF mAb)
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Combination D: avelumab plus utomilumab plus PF-04518600
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Combination F: avelumab plus CMP-001 (TLR9 agonist) and avelumab plus CMP-001 plus utomilumab and avelumab plus CMP-001 and PF-04518600 Each combination will be studied individually in 2 study parts: 1) a Phase 1b Lead-in part to evaluate safety, and determine the maximum tolerated dose (MTD) or maximum administered dose (MAD) and RP2D (if applicable), of the combination, and 2) a Phase 2 part to evaluate efficacy and further evaluate safety of the selected dose from the Phase 1b portion in pre-specified patient populations.
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
---|---|
Experimental: Cohort A1 NSCLC patients treated with avelumab + utomilumab (Dose level 1) |
Drug: Avelumab
Anti-PD-L1 antibody
Other Names:
Drug: Utomilumab
Anti-4-1BB antibody
Other Names:
|
Experimental: Cohort A2 NSCLC patients treated with avelumab + utomilumab (Dose level 2) |
Drug: Avelumab
Anti-PD-L1 antibody
Other Names:
Drug: Utomilumab
Anti-4-1BB antibody
Other Names:
|
Experimental: Cohort A3 NSCLC patients treated with avelumab + utomilumab (Dose level 3) |
Drug: Avelumab
Anti-PD-L1 antibody
Other Names:
Drug: Utomilumab
Anti-4-1BB antibody
Other Names:
|
Experimental: Cohort A4 Melanoma patients treated with avelumab +utomilumab |
Drug: Avelumab
Anti-PD-L1 antibody
Other Names:
Drug: Utomilumab
Anti-4-1BB antibody
Other Names:
|
Experimental: Cohort A5 SCCHN patients treated with avelumab + utomilumab |
Drug: Avelumab
Anti-PD-L1 antibody
Other Names:
Drug: Utomilumab
Anti-4-1BB antibody
Other Names:
|
Experimental: Cohort A6 TNBC patients treated with avelumab + utomilumab |
Drug: Avelumab
Anti-PD-L1 antibody
Other Names:
Drug: Utomilumab
Anti-4-1BB antibody
Other Names:
|
Experimental: Cohort A7 SCLC that has progressed after at least 1 line of platinum-containing therapy treated with avelumab +utomilumab |
Drug: Avelumab
Anti-PD-L1 antibody
Other Names:
Drug: Utomilumab
Anti-4-1BB antibody
Other Names:
|
Experimental: Cohort A8 NSCLC first-line Stage IV treated with avelumab +PF-05082566 |
Drug: Avelumab
Anti-PD-L1 antibody
Other Names:
Drug: Utomilumab
Anti-4-1BB antibody
Other Names:
|
Experimental: Combination B Dose Escalation PF-04518600 + avelumab in selected tumor types |
Drug: Avelumab
Anti-PD-L1 antibody
Other Names:
Drug: PF-04518600
OX40 Agonist
|
Experimental: Combination B Expansion Cohorts PF-04518600 + avelumab in selected tumor types |
Drug: Avelumab
Anti-PD-L1 antibody
Other Names:
Drug: PF-04518600
OX40 Agonist
|
Experimental: Combination C Dose escalation cohorts PD 0360324 + avelumab in selected tumor types |
Drug: Avelumab
Anti-PD-L1 antibody
Other Names:
Drug: PD 0360324
Anti-M-CSF
|
Experimental: Combination C Dose expansion cohorts PD 0360324 + aveluamb in selected tumor types |
Drug: Avelumab
Anti-PD-L1 antibody
Other Names:
Drug: PD 0360324
Anti-M-CSF
|
Experimental: Combination D Dose escalation cohorts PF-05082566 + PF-04518600 + avelumab in selected tumor types |
Drug: Avelumab
Anti-PD-L1 antibody
Other Names:
Drug: Utomilumab
Anti-4-1BB antibody
Other Names:
Drug: PF-04518600
OX40 Agonist
|
Experimental: Combination D Dose expansion cohorts PF-05082566 + PF-04518600 + avelumab in selected tumor types |
Drug: Avelumab
Anti-PD-L1 antibody
Other Names:
Drug: Utomilumab
Anti-4-1BB antibody
Other Names:
Drug: PF-04518600
OX40 Agonist
|
Experimental: Cohort A9 NSCLC first-line Stage IV treated with avelumab +utomilumab (sequential starting with utomilumab monotherapy followed by combination) |
Drug: Avelumab
Anti-PD-L1 antibody
Other Names:
Drug: Utomilumab
Anti-4-1BB antibody
Other Names:
|
Experimental: Cohort A10 NSCLC first-line Stage IV treated with avelumab + utomilumab (sequential starting with avelumab monotherapy followed by combination) |
Drug: Avelumab
Anti-PD-L1 antibody
Other Names:
Drug: Utomilumab
Anti-4-1BB antibody
Other Names:
|
Experimental: Cohort F1 CMP-001 +avelumab in SCCHN |
Drug: Avelumab
Anti-PD-L1 antibody
Other Names:
Drug: CMP-001
TLR9 agonist
|
Experimental: Cohort F2 CMP-001+avelumab+utomilumab in SCCHN |
Drug: Avelumab
Anti-PD-L1 antibody
Other Names:
Drug: Utomilumab
Anti-4-1BB antibody
Other Names:
Drug: CMP-001
TLR9 agonist
|
Experimental: Cohort F3 CMP-001 +avelumab+PF-04518600 in SCCHN |
Drug: Avelumab
Anti-PD-L1 antibody
Other Names:
Drug: PF-04518600
OX40 Agonist
Drug: CMP-001
TLR9 agonist
|
Outcome Measures
Primary Outcome Measures
- Number of participants with Dose-Limiting Toxicities (DLT) [First 8 weeks of treatment (Combination A-D) First 4 weeks of treatment (CombinationF)]
For Phase 1b: DLTs for Combination A (avelumab and PF-05082566) or Combination B (avelumab and PF-04518600) or Combination C (avelumab and PD 0360324) or Combination D (Avelumab and utomilumab and PF-04518600)occurring during the first 8 weeks of treatment (first 2 cycles). For Phase 1b: DLT for Combination F (avelumab plus CMP-001 and utomilumab or PF-04518600) occurring during the first 4 weeks of treatment (first cycle).
- Objective Response - Number of Participants With Objective Response [Baseline up to approximately 24 months]
For Phase 2: Number of participants with objective response (ie, confirmed complete or partial response according to RECIST Version 1.1).
Secondary Outcome Measures
- Cmax of avelumab (MSB0010718C) [Pre-dose and 1 hour post-dose on Days 1, 8, and 15 of Cycle 1, then on Day 1 of Cycles 2, 4, 6, and 10]
Cmax defined as the maximum plasma concentration of avelumab (MSB0010718C)
- Cmax of PF-05082566 [Pre-dose and 1 hour post-dose on Days 1, 8, and 15 of Cycle 1, and then on Day 1 of Cycles 3, 5, 8, and 12]
Cmax defined as the maximum plasma concentration of PF-05082566
- Ctrough of avelumab (MSB0010718C) [Pre-dose and 1 hour post-dose on Days 1, 8, and 15 of Cycle 1, then on Day 1 of Cycles 2, 4, 6, and 10]
Ctrough is defined as the trough plasma concentration at the end of an avelumab dosage interval.
- Ctrough of PF-05082566 [Pre-dose and 1 hour post-dose on Days 1, 8, and 15 of Cycle 1, and then on Day 1 of Cycles 3, 5, 8, and 12]
Ctrough is defined as the trough plasma concentration at the end of a PF-05082566 dosage interval.
- Anti-Drug Antibody (ADA) levels of avelumab (MSB0010718C) [Pre-dose on Day 1 of Cycles 1, 2, 4, 6, and 10]
Immunogenicity assessment of avelumab (MSB0010718C).
- Anti-Drug Antibody (ADA) levels of PF-05082566 [Pre-dose on Day 1 of Cycles 1, 3, 5, 8, and 12]
Immunogenicity assessment of PF-05082566.
- Time to Tumor Response (TTR) [Baseline up to approximately 24 months]
Time to Tumor Response (TTR) is defined for patients with confirmed objective response (CR or PR) as the time from the date of randomization (NSCLC) or date of first dose of study treatment (melanoma and SCCHN) to the first documentation of objective tumor response.
- Duration of Response (DR) [Baseline up to approximately 24 months]
Duration of Response (DR) is defined for patients with confirmed objective response (CR or PR) as the time from the first documentation of objective tumor response to the first documentation of objective tumor progression or to death due to any cause, whichever occurs first.
- Progression-Free Survival (PFS) [Baseline up to approximately 24 months]
Progression-Free Survival (PFS) is defined as the time from the date of randomization (NSCLC) or date of first dose of study treatment (melanoma and SCCHN) to the date of disease progression by RECIST v1.1 or death due to any cause, whichever occurs first.
- Overall Survival (OS) [Baseline up to approximately 24 months]
Overall Survival (OS) is defined as the time from the date of randomization (NSCLC) or date of first dose of study treatment (melanoma and SCCHN) to the date of death.
- Tumor tissue biomarkers [Baseline]
Tumor tissue biomarkers, including, but not limited to, PD-L1 expression and tumor infiltrating CD8+ T lymphocytes
- Cmax of PF-04518600 [Pre-dose and 1 hour post-dose on Days 1, 8, and 15 of Cycle 1, then on Day 1 of Cycles 2, 4, 6, and 10]
Cmax defined as the maximum plasma concentration of PF-04518600
- Anti-Drug Antibody (ADA) levels of PF-04518600 [Pre-dose on Day 1 of Cycles 1, 2, 4, 6, and 10]
Immunogenicity assessment of PF-04518600.
- Ctrough of PF-04518600 [Pre-dose and 1 hour post-dose on Days 1, 8, and 15 of Cycle 1, then on Day 1 of Cycles 2, 4, 6, and 10]
Ctrough is defined as the trough plasma concentration at the end of a PF-04518600 dosage interval.
Eligibility Criteria
Criteria
Inclusion Criteria:
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Histological or cytological diagnosis of advanced/metastatic solid tumor. Measurable disease by RECIST 1.1 with at least 1 measurable lesion that has not been previously irradiated. Availability of tumor specimen taken within 1 year prior to study entry, with no intervening systemic anti-cancer therapy. No prior PD-1/PDL-1 therapy allowed. Combination A: Phase 1b, patients with NSCLC that have progressed on standard therapy or for which no standard therapy is available, and Phase 2, patients with NSCLC, melanoma, SCCHN, TNBC in any line of therapy, SCLC, 1st line NSCLC. 1st line NSCLC must demonstrate to express PD-L1. Activating EGFR mutation, ALK, ROS1 translocation/rearrangements are not permitted. Combination B: Phase 1b, patients with advanced solid tumors (NSCLC, SCCHN, melanoma) that have progressed on standard therapy or for which no standard therapy is available, and Phase 2, patients with NSCLC, melanoma, or SCCHN. Up to 2 lines of prior therapy in advanced/metastatic disease setting allowed. Activating EGFR mutation, ALK, ROS1 translocation/rearrangements are not permitted. Combination C: Ovarian cancer, SCCHN, NSCLC, gastric cancer, platinum resistant ovarian cancer. Up to 2 lines of prior therapy in advanced/metastatic disease setting allowed. TGCT/PVNS that is either inoperable or requires extensive resection. Prior treatment with agents targeting CSF-1/CSF-1R not allowed. NSCLC activating EGFR mutation, ALK, ROS1 translocation/rearrangements are not permitted. Combination D: NSCLC, melanoma, SCCHN, bladder cancer. NSCLC activating EGFR mutation, ALK, ROS1 translocation/rearrangements are not permitted. Up to 2 lines of prior therapy in advanced/metastatic disease setting allowed. Combination F: Recurrent or metastatic SCCHN. One to three prior lines of systemic therapy for advanced stage or metastatic disease. Patients must have received anti PD-1/PD-L1 containing therapy (requires at least two doses of PD-1/PD-L1 agent).Disease progression no earlier than 6 weeks from initiation of the latest anticancer therapy. Evidence of radiologic progression is required. • Patient must be a candidate for intralesional administration with at least one tumor lesion which can be injected safely.
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ECOG performance status 0 or 1
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Estimated life expectancy of at least 3 months
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Adequate bone marrow, renal, and liver function
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Resolved acute effects of prior therapy
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Negative serum pregnancy test at screening
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Male and female patients able to have children must agree to use at least 1 highly effective method of contraception throughout the study and for at least 90 days after last dose
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Signed and dated informed consent
Exclusion Criteria:
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Monoclonal antibody based anti-cancer therapy within 28 days prior to study entry or small-molecule based anti-cancer therapy (targeted therapy or chemotherapy) within 14 days prior to study entry. Combination F:PD-1/PD-L1 agent within 14 days prior study entry.
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Current or prior use of immunosuppressive medication within 7 days prior to study entry
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Active autoimmune disease requiring systemic steroids or immunosuppressive agents within 7 days prior to study entry
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Known prior or suspected hypersensitivity to investigational products
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Major surgery within 4 weeks or radiation therapy within 14 days prior to study entry
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Patients with known symptomatic brain metastases requiring steroids
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Previous high-dose chemotherapy requiring stem cell rescue
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Prior allogeneic stem cell transplant or organ graft
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Any of the following within 6 months prior to study entry: myocardial infarction, uncontrolled angina, coronary/peripheral artery bypass graft, symptomatic congestive heart failure, cerebrovascular accident, or transient ischemic attack
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Symptomatic pulmonary embolism within 6 months prior to study entry
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Known HIV or AIDS-related illness
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Active infection requiring systemic therapy
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Positive HBV or HCV test indicating acute or chronic infection
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Administration of a live vaccine within 4 weeks prior to study entry
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Diagnosis of other malignancy within 5 years, except for adequately treated basal cell or squamous cell skin cancer, or carcinoma in situ of the breast or cervix, or low-grade (Gleason ≤6) prostate cancer
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Participation in other studies involving investigational drug(s) within 4 weeks prior to study entry and/or during study participation
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Persisting toxicity related to prior therapy >Grade 1
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Other severe acute or chronic medical condition
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Combo C :Existing periorbital edema.
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Combo C : Hypocalcemia, clinically significant bone disease or recent bone fracture (within 12 weeks prior study entry)
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
---|---|---|---|---|---|
1 | UCSD Medical Center - Encinitas | Encinitas | California | United States | 92024 |
2 | Koman Family Outpatient Pavilion | La Jolla | California | United States | 92037 |
3 | UC San Diego Medical Center - La Jolla (Jacobs Medical Center / Thornton Pavilion) | La Jolla | California | United States | 92037 |
4 | UC San Diego Perlman Medical Offices | La Jolla | California | United States | 92037 |
5 | UC San Diego Moores Cancer Center | La Jolla | California | United States | 92093 |
6 | UCLA Clinical Research Unit (Adminstration Office) | Los Angeles | California | United States | 90024 |
7 | Ronald Reagan UCLA Medical Center | Los Angeles | California | United States | 90095 |
8 | UCLA Hematology-Oncology Clinic | Los Angeles | California | United States | 90095 |
9 | UCLA Hematology-Oncology Infusion Center | Los Angeles | California | United States | 90095 |
10 | UC San Diego Medical Center - Hillcrest | San Diego | California | United States | 92103 |
11 | UCSD Medical Center - Vista | Vista | California | United States | 92081 |
12 | Georgetown University Medical Center | Washington | District of Columbia | United States | 20007 |
13 | Mount Sinai Comprehensive Cancer Center - Aventura | Aventura | Florida | United States | 33180 |
14 | Mount Sinai Comprehensive Cancer Center | Miami Beach | Florida | United States | 33140 |
15 | Florida Cancer Specialists | Sarasota | Florida | United States | 34232 |
16 | H Lee Moffitt Cancer Center and Research Institute | Tampa | Florida | United States | 33612 |
17 | University of Iowa Hospitals and Clinics | Iowa City | Iowa | United States | 52242 |
18 | University of Michigan Hospitals | Ann Arbor | Michigan | United States | 48109-5008 |
19 | University of Michigan | Ann Arbor | Michigan | United States | 48109 |
20 | Investigational Pharmacy, Karmanos Cancer Center | Detroit | Michigan | United States | 48201 |
21 | Karmanos Cancer Institute | Detroit | Michigan | United States | 48201 |
22 | Karmanos Cancer Institute Weisberg Cancer Treatment Center | Farmington Hills | Michigan | United States | 48334 |
23 | VA NY Harbor Healthcare System | New York | New York | United States | 10010 |
24 | NYU Investigational Pharmacy | New York | New York | United States | 10016 |
25 | NYU Langone Medical Center | New York | New York | United States | 10016 |
26 | NYU Laura and Isaac Perlmutter Cancer Center | New York | New York | United States | 10016 |
27 | Weill Cornell Medical College | New York | New York | United States | 10021 |
28 | Research Pharmacy #PH# | New York | New York | United States | 10065 |
29 | Weill Cornell Medical College/New York Presbyterian Hospital | New York | New York | United States | 10065 |
30 | Sampson Regional Medical Center | Clinton | North Carolina | United States | 28328 |
31 | Southeastern Medical Oncology Center | Clinton | North Carolina | United States | 28328 |
32 | Southeastern Medical Oncology Center | Goldsboro | North Carolina | United States | 27534 |
33 | Wayne Memorial Hospital | Goldsboro | North Carolina | United States | 27534 |
34 | Onslow Memorial Hospital | Jacksonville | North Carolina | United States | 28546 |
35 | Southeastern Medical Oncology Center | Jacksonville | North Carolina | United States | 28546 |
36 | Fox Chase Cancer Center | Philadelphia | Pennsylvania | United States | 19111 |
37 | University of Pittsburgh Cancer Institute | Pittsburgh | Pennsylvania | United States | 15232 |
38 | UPCI Investigational Drug Service | Pittsburgh | Pennsylvania | United States | 15232 |
39 | UPMC Shadyside Hospital | Pittsburgh | Pennsylvania | United States | 15232 |
40 | Rhode Island Hospital | Providence | Rhode Island | United States | 02903 |
41 | Miriam Hospital | Providence | Rhode Island | United States | 02906 |
42 | Sanford Cancer Center Oncology Clinic & Pharmacy | Sioux Falls | South Dakota | United States | 57104 |
43 | Sanford Gynecologic Oncology Clinic | Sioux Falls | South Dakota | United States | 57104 |
44 | Sanford Interventional Radiology | Sioux Falls | South Dakota | United States | 57104 |
45 | Sanford ENT Clinic | Sioux Falls | South Dakota | United States | 57105 |
46 | Sanford Research | Sioux Falls | South Dakota | United States | 57105 |
47 | Sanford USD Medical Center | Sioux Falls | South Dakota | United States | 57105 |
48 | Tennessee Oncology, PLLC | Nashville | Tennessee | United States | 37203 |
49 | The Sarah Cannon Research Institute / Tennessee Oncology, PLLC | Nashville | Tennessee | United States | 37203 |
50 | Henry-Joyce Cancer Clinic | Nashville | Tennessee | United States | 37232 |
51 | Vanderbilt University Oncology Pharmacy | Nashville | Tennessee | United States | 37232 |
52 | University of Texas Southwestern Medical Center | Dallas | Texas | United States | 75390 |
53 | UT Southwestern Simmons Comprehensive Cancer Center | Dallas | Texas | United States | 75390 |
54 | The University of Texas MD Anderson Cancer Center | Houston | Texas | United States | 77030 |
55 | Seattle Cancer Care Alliance | Seattle | Washington | United States | 98109 |
56 | University of Washington Medical Center | Seattle | Washington | United States | 98195 |
57 | Chris O'Brien Lifehouse | Camperdown | New South Wales | Australia | 2050 |
58 | Macquarie University | Macquarie University | New South Wales | Australia | 2109 |
59 | Melanoma Institute Australia | North Sydney | New South Wales | Australia | 2060 |
60 | The Mater Hospital | North Sydney | New South Wales | Australia | 2060 |
61 | Baxter Healthcare | Old Toongabie | New South Wales | Australia | 2146 |
62 | Brighton Medical Imaging | Brighton | Victoria | Australia | 3186 |
63 | Cabrini Hospital Brighton | Brighton | Victoria | Australia | 3186 |
64 | Austin Health | Heidelberg | Victoria | Australia | 3084 |
65 | Cabrini Hospital Malvern | Malvern | Victoria | Australia | 3144 |
66 | Cabrini Hospital | Malvern | Victoria | Australia | 3144 |
67 | Malvern Medical Imaging | Malvern | Victoria | Australia | 3144 |
68 | Macquarie Heart | New South Wales | Australia | 2109 | |
69 | Cross Cancer Institute | Edmonton | Alberta | Canada | T6G 1Z2 |
70 | British Columbia Cancer Agency - Vancouver Centre | Vancouver | British Columbia | Canada | V5Z 4E6 |
71 | The Ottawa Hospital Cancer Centre | Ottawa | Ontario | Canada | K1H 8L6 |
72 | Princess Margaret Cancer Centre | Toronto | Ontario | Canada | M5G 2M9 |
73 | PH 145294, Centre Hospitalier de l'Universite de Montreal (CHUM), Oncology Research Pharmacy | Montreal | Quebec | Canada | H2X 0C2 |
74 | Centre Hospitalier de l'Université de Montréal (CHUM) | Montreal | Quebec | Canada | H2X 3E4 |
75 | Institut Gustave Roussy | Villejuif | Cedex | France | 94805 |
76 | Institut Gustave Roussy | Villejuif | France | 94805 | |
77 | National Cancer Center Hospital East | Kashiwa | Chiba | Japan | 277-8577 |
78 | National Cancer Center Hospital | Chuo-ku | Tokyo | Japan | 104-0045 |
79 | Narodowy Instytut Onkologii im. Marii Sklodowskiej-Curie - Panstwowy Instytut Badawczy | Warszawa | Mazowieckie | Poland | 02-781 |
80 | Narodowy Instytut Onkologii im. Marii Sklodowskiej-Curie - Panstwowy Instytut Badawczy | Warszawa | Poland | 02-781 | |
81 | Investigational Drug Services, National Taiwan University Hospital | Taipei | Taiwan | 100 | |
82 | National Taiwan University Hospital | Taipei | Taiwan | 100 | |
83 | The Royal Marsden Hospital | London | United Kingdom | SW3 6JJ | |
84 | The Royal Marsden NHS Foundation Trust | London | United Kingdom | SW3 6JJ | |
85 | Sarah Cannon Research Institute UK | London | United Kingdom | W1G 6AD | |
86 | The Harley Street Clinic | London | United Kingdom | W1G 7LJ | |
87 | The Harley Street Clinic | London | United Kingdom | W1G 8PP |
Sponsors and Collaborators
- Pfizer
Investigators
- Study Director: Pfizer CT.gov Call Center, Pfizer
Study Documents (Full-Text)
None provided.More Information
Additional Information:
Publications
None provided.- B9991004
- 2015-002552-27
- JAVELIN MEDLEY