Memorial Sloan Kettering Cancer Center, New York, NY
Jedd D. Wolchok , Vanna Chiarion-Sileni , Rene Gonzalez , Piotr Rutkowski , Jean Jacques Grob , C. Lance Cowey , Christopher Lao , Dirk Schadendorf , Pier Francesco Ferrucci , Michael Smylie , Reinhard Dummer , Andrew Hill , John B. A. G. Haanen , Michele Maio , Grant A. McArthur , Dana Walker , Joel Jiang , Christine E. Horak , James M. G. Larkin , F. Stephen Hodi
Background: In CheckMate 067, NIVO (anti-PD-1) plus IPI (anti-CTLA-4) significantly improved progression-free survival (PFS) and objective response rate (ORR) vs IPI alone in pts with MEL (N Engl J Med 2015;373:23). We report updated efficacy and safety results from this study. Methods: Treatment-naïve pts (N=945) were randomized 1:1:1 to NIVO 1 mg/kg Q3W + IPI 3 mg/kg Q3W for 4 doses (followed by NIVO 3 mg/kg Q2W), NIVO 3 mg/kg Q2W + placebo, or IPI 3 mg/kg Q3W for 4 doses + placebo, until progression or unacceptable toxicity. Pts were stratified by PD-L1 status, BRAFmutation status, and M-stage. Co-primary endpoints were PFS and overall survival (data remain immature). Secondary endpoints included efficacy by PD-L1 status and safety. Results: At ≥18 months of follow-up, median PFS continued to be significantly longer for NIVO+IPI and NIVO vs IPI (P<0.001), and was numerically longer for NIVO+IPI vs NIVO alone (Table). Median duration of response in 181/314 (57.6%) NIVO+IPI responders has not been reached, and was 22.3 and 14.4 months in 138/316 (43.7%) NIVO and 60/315 (19.0%) IPI responders, respectively. Median PFS was also numerically longer with NIVO+IPI vs NIVO or IPI regardless of PD-L1 tumor expression (Table). For NIVO+IPI, NIVO, and IPI groups, median PFS was 15.5, 5.6, and 4.0 months in pts with a BRAF mutation and was 11.3, 7.1, and 2.8 months in pts with wild-type BRAF, respectively. The frequency and types of drug-related grade 3/4 AEs were consistent with earlier reports (NIVO+IPI, 56.5%; NIVO, 19.8%; IPI, 27.0%). Conclusions: NIVO+IPI and NIVO alone continue to demonstrate superior clinical activity vs IPI monotherapy. NIVO+IPI appears to have greater efficacy than either agent alone, regardless of PD-L1 expression or BRAF mutation status. Clinical trial information: NCT01844505
Median PFS (95% CI) | NIVO+IPI | NIVO | IPI |
---|---|---|---|
ITT population | 11.5 (8.9–16.7) | 6.9 (4.3–9.5) | 2.9 (2.8–3.4) |
HR (95% CI) vs NIVO | 0.76 (0.60–0.92)a | — | — |
PD-L1 expression | |||
≥5% | NR (9.7–NR) | 22.0 (8.9–NR) | 3.9 (2.8–4.2) |
HR (95% CI) vs NIVO | 0.87 (0.54–1.41)a | — | — |
<5% | 11.1 (8.0–22.2) | 5.3 (2.8–7.1) | 2.8 (2.8–3.1) |
HR (95% CI) vs NIVO | 0.74 (0.58–0.96)a | — | — |
HR, hazard ratio; NR, not reached. aExploratory endpoint.
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Abstract Disclosures
2023 ASCO Annual Meeting
First Author: Dirk Schadendorf
2022 ASCO Annual Meeting
First Author: F. Stephen Hodi
2015 ASCO Annual Meeting
First Author: Jedd D. Wolchok
2021 ASCO Annual Meeting
First Author: Jedd D. Wolchok