Efficacy and safety of nivolumab (NIVO) in patients with advanced melanoma (MEL) and poor prognostic factors who progressed on or after ipilimumab (IPI): Results from a phase II study (CheckMate 172).

Authors

null

Dirk Schadendorf

University Hospital Essen, Essen, Germany

Dirk Schadendorf , Paolo Antonio Ascierto , John B. A. G. Haanen , Enrique Espinosa , Lev V. Demidov , Claus Garbe , Paul Lorigan , Helen Gogas , Christoph Hoeller , Tormod Kyrre Guren , Andree Rorive , Piotr Rutkowski , Eva Muñoz-Couselo , Reinhard Dummer , Ana Carneiro , Geke Hospers , Elena Borisovna Grigoryeva , Rafia Bhore , Paul Nathan

Organizations

University Hospital Essen, Essen, Germany, Istituto Nazionale Tumori “Fondazione G.Pascale”- IRCCS, Naples, Italy, Netherlands Cancer Institute, Amsterdam, Netherlands, Hospital Universitario La Paz, Madrid, Spain, Russian Cancer Research Centre, Moscow, Russian Federation, Eberhard Karls University, Tübingen, Germany, The Christie Hospital NHS Foundation Trust, Manchester, United Kingdom, University of Athens, Athens, Greece, Medical University of Vienna, Vienna, Austria, Oslo University Hospital, Oslo, Norway, CHU Sart Tilman Liège, Liège, Belgium, Sklodowska-Curie Memorial Cancer Center, Warsaw, Poland, Vall d'Hebron University Hospital, Barcelona, Spain, University of Zurich Hospital, Zurich, Switzerland, Lund University Hospital and Lund University, Lund, Sweden, University Medical Center Groningen, Groningen, Netherlands, Bristol-Myers Squibb, Princeton, NJ, Mount Vernon Cancer Centre, London, United Kingdom

Research Funding

Pharmaceutical/Biotech Company

Background: In the phase III CheckMate 037 study, NIVO improved the objective response rate and progression-free survival with less toxicity vs chemotherapy in patients (pts) with MEL who progressed after prior IPI treatment. We report the first efficacy and updated safety data from pts with MEL in CheckMate 172, including those with rare melanoma subtypes (uveal, mucosal), brain metastases, or an ECOG performance status (PS) of 2. Methods: In this ongoing phase II, single-arm, open-label, multicenter study, pts with MEL who progressed on or after IPI were treated with NIVO 3 mg/kg Q2W for up to 2 years until progression or unacceptable toxicity (NCT02156804). We report efficacy and updated safety data from 734 treated pts with ≥1 year of follow-up (database lock: November 2016). Results: Of 734 pts, 50% had LDH>ULN, 7% ECOG PS 2, 66% M1c disease, 15% a history of brain metastases, and 23% received ≥3 prior therapies. Overall, 593 pts (81%) received more than 4 doses of NIVO. Overall, response rate at 12 weeks was 32%, with a complete response in 1% (Table). The 1-year overall survival (OS) rate was 63%. Any grade and grade 3/4 treatment-related adverse events (AEs) occurred in 66% and 17% of pts, respectively. Discontinuations due to treatment-related AEs occurred in 4% of pts. The most common treatment-related select (potentially immune-related) AEs were diarrhea (12%), hypothyroidism (9%), and pruritus (7%). Conclusions: CheckMate 172 is the largest study of NIVO efficacy and safety in pts with MEL who progressed on or after IPI. NIVO demonstrated a safety profile consistent with that of prior clinical trials. Efficacy outcomes were encouraging in some difficult-to-treat subgroups of pts with poor prognostic factors, such as mucosal melanoma and brain metastases. Clinical trial information: NCT02156804

Total pts (N=734)ECOG PS 2(n=48)Uveal
(n=75)
Mucosal (n=52)CNS
(n=112)
Response rate at 12 wks, % (n)*32 (123/386)15 (2/13)6 (2/34)21 (5/24)43 (20/47)
Median OS, mos (95% CI)19 (17–NR)2 (1–4)11 (7–15)13 (6–NR)13 (9–NR)
1-year OS rate, % (95% CI)63 (60–67)14 (6–26)47 (34-59)53 (38–67)51 (40–60)

*Assessed in evaluable pts on treatment for ≥12 weeks; NR=not reached.

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Abstract Details

Meeting

2017 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Melanoma/Skin Cancers

Track

Melanoma/Skin Cancers

Sub Track

Advanced/Metastatic Disease

Clinical Trial Registration Number

NCT02156804

Citation

J Clin Oncol 35, 2017 (suppl; abstr 9524)

DOI

10.1200/JCO.2017.35.15_suppl.9524

Abstract #

9524

Poster Bd #

132

Abstract Disclosures