Updated results from a phase III trial of nivolumab (NIVO) combined with ipilimumab (IPI) in treatment-naive patients (pts) with advanced melanoma (MEL) (CheckMate 067).

Authors

Jedd Wolchok

Jedd D. Wolchok

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

Organizations

Memorial Sloan Kettering Cancer Center, New York, NY, Oncology Institute of Veneto IRCCS, Padua, Italy, University of Colorado Cancer Center, Denver, CO, Sklodowska-Curie Memorial Cancer Center, Warsaw, Poland, Hospital de la Timone, Marseille, France, Texas Oncology/Baylor Sammons Cancer Center/US Oncology, Dallas, TX, University of Michigan, Ann Arbor, MI, Department of Dermatology, University of Essen, Essen, Germany, European Institute of Oncology, Milan, Italy, Cross Cancer Institute, Edmonton, AB, Canada, Universitats Spital, Zurich, Switzerland, Tasman Oncology Research, Queensland, Australia, Netherlands Cancer Institute, Amsterdam, Netherlands, Medical Oncology and Immunotherapy University Hospital of Siena, Siena, Italy, Peter MacCallum Cancer Centre, East Melbourne, Australia, Bristol-Myers Squibb, Princeton, NJ, The Royal Marsden Hospital, London, United Kingdom, Dana-Farber Cancer Institute, Boston, MA

Research Funding

Pharmaceutical/Biotech Company

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+IPINIVOIPI
ITT population11.5 (8.9–16.7)6.9 (4.3–9.5)2.9 (2.8–3.4)
HR (95% CI) vs NIVO0.76 (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 NIVO0.87 (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 NIVO0.74 (0.58–0.96)a

HR, hazard ratio; NR, not reached. aExploratory endpoint.

Disclaimer

This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org

Abstract Details

Meeting

2016 ASCO Annual Meeting

Session Type

Oral Abstract Session

Session Title

Melanoma/Skin Cancers

Track

Melanoma/Skin Cancers

Sub Track

Advanced/Metastatic Disease

Clinical Trial Registration Number

NCT01844505

Citation

J Clin Oncol 34, 2016 (suppl; abstr 9505)

DOI

10.1200/JCO.2016.34.15_suppl.9505

Abstract #

9505

Abstract Disclosures