Nivolumab + ipilimumab combination in patients with DNA mismatch repair-deficient/microsatellite instability-high (dMMR/MSI-H) metastatic colorectal cancer (mCRC): First report of the full cohort from CheckMate-142.

Authors

Thierry Andre

Thierry Andre

Saint-Antoine Hospital, Paris, France

Thierry Andre , Sara Lonardi , Mark Wong , Heinz-Josef Lenz , Fabio Gelsomino , Massimo Aglietta , Michael Morse , Eric Van Cutsem , Raymond S. McDermott , Andrew G Hill , Michael B. Sawyer , Alain Hendlisz , Bart Neyns , Magali Svrcek , Rebecca Anne Moss , Jean-Marie Ledeine , Z. Alexander Cao , Shital Kamble , Scott Kopetz , Michael J. Overman

Organizations

Saint-Antoine Hospital, Paris, France, Istituto Oncologico Veneto, IRCCS, Padova, Italy, University of Sydney Medical School, Sydney, Australia, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA, University Hospital of Modena, Modena, Italy, University of Torino, Turin, Italy, Duke University Medical Center, Durham, NC, University Hospitals Gasthuisberg Leuven and KU Leuven, Leuven, Belgium, St. Vincent's University Hospital, Dublin, Ireland, Tasman Oncology Research Pty Ltd, Queensland, Australia, Cross Cancer Institute, Edmonton, AB, Canada, Institut Jules Bordet/ Université Libre de Bruxelles, Brussels, Belgium, Universitair Ziekenhuis Brussel, Brussels, Belgium, Bristol-Myers Squibb, Princeton, NJ, Bristol-Myers Squibb, Brussels, Belgium, University of Texas MD Anderson Cancer Center, Houston, TX

Research Funding

Pharmaceutical/Biotech Company

Background: Nivolumab (NIVO) provided durable responses (investigator-assessed [INV] ORR, 31%) and disease control (DCR, 69%) in pretreated pts with dMMR/MSI-H mCRC in CheckMate-142 (NCT02060188; Overman et al Lancet Oncol 2017). An interim analysis of the NIVO + ipilimumab (IPI) combination cohort of CheckMate-142 reported a preliminary ORR of 55% and manageable safety profile in a subset of pts (n = 84) with dMMR/MSI-H mCRC and ≥ 6 mo of follow-up (André et al ASCO 2017). Here we report for the first time efficacy and safety from the complete population (N = 119) of the NIVO + IPI cohort of CheckMate-142, which is the largest single-study report of an immunotherapy regimen in pts with dMMR/MSI-H mCRC. Methods: Pts with dMMR/MSI-H mCRC received NIVO 3 mg/kg + IPI 1 mg/kg Q3W for 4 doses followed by NIVO 3 mg/kg Q2W. Primary endpoint was ORR (INV; RECIST 1.1). Other endpoints were DOR, PFS, OS, and safety/tolerability. Results: Of 119 treated pts, 76% had ≥ 2 prior lines of therapy. Median follow-up was 13.4 mo. The ORR was 55% and DCR was 80% (Table). Notably, ORR in pts with a BRAF mutation was 55%. Among all responders, median DOR was not reached (NR), with 94% of responses ongoing at data cutoff. Tumor burden was reduced from baseline in 77% of pts. The 9-mo PFS and OS rates were 76% and 87%, respectively. Gr 3–4 TRAEs occurred in 32% of pts; 13% (any gr) and 10% (gr 3–4) of pts had TRAEs that led to discontinuation. No treatment-related deaths were reported. Results including a similar follow-up of the NIVO arm will also be presented. Conclusions: In the largest cohort of dMMR/MSI-H pts treated with an immunotherapy regimen, NIVO + IPI built on the efficacy reported with NIVO monotherapy, demonstrating enhanced clinical benefit and manageable safety, and may represent a new standard of care in pts with dMMR/MSI-H mCRC. Clinical trial information: NCT02060188

Table. Efficacy (INV)

NIVO + IPI
(N = 119)
ORR, n (%)
95% CI
65 (55)
45.2, 63.8
    CR4 (3)
    PR61 (51)
    SD37 (31)
    PD14 (12)
    Unknown3 (3)
DCR, n (%)a
95% CI
95 (80)
71.5, 86.6
Median DOR [95% CI], moNR [NE]
Median PFS [95% CI], mo
9-mo rate, %
NR [NE]
76
Median OS [95% CI], mo
9-mo rate, %
NR [NE]
87

NE = not estimable

aCR + PR + SD ≥ 12 wk

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Abstract Details

Meeting

2018 Gastrointestinal Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session C: Cancers of the Colon, Rectum, and Anus

Track

Cancers of the Colon, Rectum, and Anus

Sub Track

Multidisciplinary Treatment

Clinical Trial Registration Number

NCT02060188

Citation

J Clin Oncol 36, 2018 (suppl 4S; abstr 553)

DOI

10.1200/JCO.2018.36.4_suppl.553

Abstract #

553

Poster Bd #

A2

Abstract Disclosures