Nivolumab (NIVO) + ipilimumab (IPI) combination therapy in patients (pts) with advanced hepatocellular carcinoma (aHCC): Subgroup analyses from CheckMate 040.

Authors

null

Aiwu Ruth He

Georgetown University Hospital, Washington, DC

Aiwu Ruth He , Thomas Yau , Chiun Hsu , Yoon-Koo Kang , Tae-You Kim , Armando Santoro , Bruno Sangro , Ignacio Melero , Masatoshi Kudo , Ming-Mo Hou , Ana Matilla , Francesco Tovoli , Jennifer J. Knox , Bassel F. El-Rayes , Mirelis Acosta-Rivera , Jaclyn Neely , Yun Shen , Marina Tschaika , Anthony B. El-Khoueiry

Organizations

Georgetown University Hospital, Washington, DC, The University at Hong Kong, Hong Kong, China, National Taiwan University Hospital, Taipei, Taiwan, Asan Medical Center, University of Ulsan, Seoul, South Korea, Seoul National University, Seoul, South Korea, Istituto Clinico Humanitas, Rozzano, Italy, Clinica Universidad de Navarra and CIBEREHD, Pamplona, Spain, Universidad de Navarra, Pamplona, Spain, Kindai University Faculty of Medicine, Osaka, Japan, Chang Gung Memorial Hospital, Taipei, Taiwan, Servicio de Digestivo, Hospital General Universitario Gregorio Marañón y CIBEREHD, Madrid, Spain, Department of Medical & Surgical Sciences, University of Bologna, Bologna, Italy, Princess Margaret Cancer Centre, Toronto, ON, Canada, Emory University Winship Center, Atlanata, GA, Fundación de Investigación, San Juan, PR, Bristol-Myers Squibb, Princeton, NJ, USC Norris Comprehensive Cancer Center, Los Angeles, CA

Research Funding

Pharmaceutical/Biotech Company
Bristol-Myers Squibb

Background: NIVO monotherapy is approved in the United States and other countries for pts with HCC treated with sorafenib (SOR) based on CheckMate 040 (NCT01658878) results, which reported 14% objective response rate (ORR) and 16-month median overall survival (mOS; El-Khoueiry et al. Lancet 2017). Primary efficacy and safety of NIVO + IPI in pts with aHCC previously treated with SOR were presented recently (Yau et al. J Clin Oncol 2019). Here, we will present subgroup analyses from this study. Methods: Pts were randomized to 3 arms: [A] NIVO 1 mg/kg + IPI 3 mg/kg Q3W (4 doses) or [B] NIVO 3 mg/kg + IPI 1 mg/kg Q3W (4 doses), each followed by NIVO 240 mg Q2W, or [C] NIVO 3 mg/kg Q2W + IPI 1 mg/kg Q6W. Treatment continued until intolerable toxicity or disease progression. Primary endpoints included safety/tolerability, ORR, and duration of response (DOR; investigator assessment per RECIST v1.1). Key secondary endpoints included disease control rate (DCR), OS, and progression-free survival (blinded independent central review [BICR] per RECIST v1.1); key exploratory endpoints included ORR (BICR per RECIST v1.1). Data cutoff was January 2019. Results: A total of 148 pts were randomized. Minimum OS follow-up from last pt randomization date to data cutoff was 28 months. At baseline, 34% of all pts had vascular invasion; 82% had extrahepatic spread; and 91% had Barcelona Clinic Liver Cancer stage C; 84% discontinued SOR because of disease progression and 14% because of toxicity. For all treated pts, ORR was 31% (7 had complete response), with median DOR of 17 months; DCR was 49%; the 30-month OS rate was 37%. NIVO + IPI was well tolerated; 38% of pts had grade 3–4 treatment-related adverse events (TRAEs; most common any grade: pruritus and rash; most common grade 3–4: aspartate aminotransferase increase and lipase increase); 5% had grade 3–4 TRAEs leading to discontinuation. Subgroup analyses based on duration of prior SOR therapy and other pt characteristics will be presented. Conclusions: NIVO + IPI led to clinically meaningful benefits, with a manageable safety profile in pts previously treated with SOR. NIVO + IPI may provide a new treatment option for these pts. Clinical trial information: NCT01658878

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Abstract Details

Meeting

2020 Gastrointestinal Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session B: Hepatobiliary Cancer, Neuroendocrine/Carcinoid, Pancreatic Cancer, and Small Bowel Cancer

Track

Hepatobiliary Cancer,Neuroendocrine/Carcinoid,Pancreatic Cancer,Small Bowel Cancer,Other GI Cancer

Sub Track

Therapeutics

Clinical Trial Registration Number

NCT01658878

Citation

J Clin Oncol 38, 2020 (suppl 4; abstr 512)

Abstract #

512

Poster Bd #

B15

Abstract Disclosures