A phase III randomized study of nivolumab plus ipilimumab versus nivolumab for previously treated patients with stage IV squamous cell lung cancer and no matching biomarker (Lung-MAP Sub-Study S1400I, NCT02785952).

Authors

Lyudmila Bazhenova

Lyudmila Bazhenova

University of California, San Diego, La Jolla, CA

Lyudmila Bazhenova , Mary Weber Redman , Scott N. Gettinger , Fred R. Hirsch , Philip C. Mack , Lawrence Howard Schwartz , David R. Gandara , Jeffrey D. Bradley , Tom Stinchcombe , Natasha B. Leighl , Suresh S. Ramalingam , Susan S Tavernier , Katherine Minichiello , Karen Kelly , Vassiliki Papadimitrakopoulou , Roy S. Herbst

Organizations

University of California, San Diego, La Jolla, CA, SWOG Statistical Center; Fred Hutchinson Cancer Research Center, Seattle, WA, Yale Cancer Center, New Haven, CT, University of Colorado Cancer Center, Denver, CO, UC Davis Comprehensive Cancer Center, Sacramento, CA, Columbia University Medical Center, New York, NY, University of California, Davis, Sacramento, CA, Washington University School of Medicine in St. Louis, St. Louis, MO, Duke Cancer Institute, Durham, NC, Princess Margaret Cancer Centre, Toronto, ON, Canada, Winship Cancer Institute, Emory University, Atlanta, GA, Idaho State University, Pocatello, ID, University of California Davis Comprehensive Cancer Center, Sacramento, CA, The University of Texas MD Anderson Cancer Center, Houston, TX, Yale University, New Haven, CT

Research Funding

U.S. National Institutes of Health
Pharmaceutical/Biotech Company

Background: Lung-MAP is a master protocol for patients (pts) with stage IV previously treated SqNSCLC. S1400I enrolled pts who were not eligible for a biomarker-matched sub-study. Methods: S1400I is phase III randomized trial for immunotherapy-naïve patients with ECOG 0-1 not selected by PD-L1 expression. Pts were assigned 1:1 to nivolumab and ipilimumab (N+I) vs nivolumab (N). N was given at 3 mg/kg q 2w, I was given at 1 mg/kg q 6w. The primary endpoint was overall survival (OS). Secondary endpoints: investigator-assessed progression-free survival (IA-PFS), response by RECIST 1.1, and toxicity. Results: From December 18, 2015 to April 23, 2018, 275 pts enrolled and 252 determined eligible (125 N+I and 127 N). The study was closed for futility at an interim analysis. Baseline characteristics were similar across arms. mOS was 10.0 m (8.0-12.8) and 11.0 m (8.2-13.5) for N+I and N. HR 0.97 (0.71-1.31), p 0.82. mPFS was 3.8 m (2.3-4.2) and 2.9 m (1.8-3.9) for N+I and N. HR 0.84 (0.64-1.09), p 0.19. Outcomes based on PD-L1 and TBM subsets are shown in table. Response rates were 18% (12-25%) and 17% (11-24%) for N+ I and N. Median follow up for patients still alive was 17.4 m. Grade ≥3 treatment-related AEs occurred in 48(39%) of pts on N+I vs 38(31%) on N. irAE reported in 39% of pts on N+I and 34% of patients on N. Drug-related AEs led to discontinuation in 25% and 16% of pts on N+I and N. There were 5 grade 5 AE in N+I arm and 1 in N arm. Conclusions: S1400I failed to show improvement in outcomes with N+I. Study was closed for futility at interim analysis. Toxicities were not different between two arms. Clinical trial information: 02785952.

N+I
Median in months
N
Median in months
HRp
OS PD-L1 ≥514.1 (5.8-17.5)12.0 (8.2-19.8)1.06 (0.58-1.92)0.86
OS PD-L1 < 58.3 (6.0-10.7)10.3 (6.3-13.5)1.01 (0.62-1.65)0.97
OS TMB ≥1013.1 (9.3-17.0)11.4 (8.2-16.1)0.86 (0.56-1.32)0.48
OS TMB < 107.6 (5.7-10.2)10.0 (6.3-15.2)1.08 (0.68-1.71)0.74
PFS PD-L1 ≥ 53.9 (1.7-7.1)2.9 (1.8-4.7)0.65 (0.38-1.08)0.10
PFS PD-L1 < 54.4 (2.1-6.0)1.6 (1.5-3.0)0.64 (0.41-1.01)0.06
PFS TMB ≥ 104.2 (3.4-5.9)3.4 (1.8-5.3)0.75 (0.52-1.10)0.15
PFS TMB < 101.9 (1.5-4.1)2.7 (1.6-3.3)0.92 (0.62-1.39)0.70

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Abstract Details

Meeting

2019 ASCO Annual Meeting

Session Type

Poster Discussion Session

Session Title

Lung Cancer—Non-Small Cell Metastatic

Track

Lung Cancer

Sub Track

Metastatic Non–Small Cell Lung Cancer

Clinical Trial Registration Number

02785952

Citation

J Clin Oncol 37, 2019 (suppl; abstr 9014)

DOI

10.1200/JCO.2019.37.15_suppl.9014

Abstract #

9014

Poster Bd #

337

Abstract Disclosures