Nivolumab dose escalation and expansion in patients with advanced hepatocellular carcinoma (HCC): The CheckMate 040 study.

Authors

null

Ignacio Melero

Clinica Universidad de Navarra, Pamplona, Spain

Ignacio Melero , Bruno Sangro , Thomas Cheung Yau , Chiun Hsu , Masatoshi Kudo , Todd S. Crocenzi , Tae-You Kim , SuPin Choo , Jorg Trojan , Tim Meyer , Theodore Hobart Welling III, Winnie Yeo , Akhil Chopra , Jeffrey Anderson , Christine Marie Dela Cruz , Lixin Lang , Jaclyn Neely , Hao Tang , Anthony El-Khoueiry

Organizations

Clinica Universidad de Navarra, Pamplona, Spain, Chinese University of Hong Kong, Hong Kong, China, National Taiwan University Hospital, Taipei, Taiwan, Kinki University School of Medicine, Osaka, Japan, Providence Cancer Center, Portland, OR, Seoul National University Hospital, Seoul, South Korea, National Cancer Centre, Singapore, Singapore, Goethe University, Frankfurt, Germany, Royal Free Hospital, London, United Kingdom, University of Michigan School of Medicine, Ann Arbor, MI, Johns Hopkins Singapore International Medical Centre, Singapore, Singapore, Bristol-Myers Squibb, Princeton, NJ, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA

Research Funding

Pharmaceutical/Biotech Company

Background: HCC diagnosed at advanced stages has a poor prognosis. Patients who progress on sorafenib have few options. Nivolumab, a fully human IgG4 monoclonal antibody inhibitor of programmed death-1 (PD-1), has demonstrated clinical and survival benefit in a number of tumor types. Here we report updated interim analyses of safety, efficacy, and exploratory biomarkers in patients with advanced HCC treated with nivolumab in the CheckMate 040 study (NCT01658878). Methods: Patients enrolled had advanced HCC with or without hepatitis C or B virus (HCV or HBV) infection. Prior sorafenib was allowed. Phase 1 dose-escalation evaluated nivolumab (0.1–10 mg/kg) Q2W. Phase 2 dose-expansion was initiated in 4 cohorts: sorafenib naïve/intolerant, sorafenib progressors, HCV infected, and HBV infected. All cohorts received nivolumab 3 mg/kg Q2W. The primary endpoint in the dose-escalation phase was safety/tolerability, and the primary endpoint in the dose-expansion phase was objective response rate (ORR) by RECIST v1.1 (central review). Secondary endpoints included duration of response (DOR), disease control rate (DCR), and overall survival (OS). Biomarkers within pre-treatment tumors were assessed. Results: Across dose escalation and expansion phases, 262 patients have been treated. Grade 3/4 treatment-related adverse events occurred in 20%. No maximum tolerated dose was reached during dose escalation (n = 48). The ORR (investigator-assessed) was 20% (95% CI 15–26) in 214 patients treated in the dose expansion phase with a median DoR of 9.9 months; DCR was 64% (95% CI 58–71). Responses were observed across etiologies and regardless of tumor PD-L1 expression. ORRs of 23% (95% CI 13–36) and 21% (95% CI 11–34) were observed in the uninfected sorafenib-naive and -treated patients, respectively. The 9-month overall survival rate in the expansion phase was 74% (95% CI 67–79). Association between immune-cell biomarkers and clinical outcomes will be presented. Conclusions: In this heavily pretreated population, responses to nivolumab were durable with encouraging overall survival. Safety was manageable and consistent with that observed in other solid tumors with no new safety signals. Clinical trial information: NCT01658878

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Abstract Details

Meeting

2017 Gastrointestinal Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session B: Cancers of the Pancreas, Small Bowel and Hepatobiliary Tract

Track

Cancers of the Pancreas, Small Bowel, and Hepatobiliary Tract

Sub Track

Multidisciplinary Treatment

Clinical Trial Registration Number

NCT01658878

Citation

J Clin Oncol 35, 2017 (suppl 4S; abstract 226)

DOI

10.1200/JCO.2017.35.4_suppl.226

Abstract #

226

Poster Bd #

A4

Abstract Disclosures