Nivolumab (NIVO) + low-dose ipilimumab (IPI) as first-line (1L) therapy in microsatellite instability-high/mismatch repair-deficient (MSI-H/dMMR) metastatic colorectal cancer (mCRC): Two-year clinical update.

Authors

null

Heinz-Josef Lenz

USC Norris Comprehensive Cancer Center, Los Angeles, CA

Heinz-Josef Lenz , Sara Lonardi , Vittorina Zagonel , Eric Van Cutsem , M. Luisa Limon , Mark Wong , Alain Hendlisz , Massimo Aglietta , Pilar Garcia-Alfonso , Bart Neyns , Fabio Gelsomino , Dana Backlund Cardin , Tomislav Dragovich , Usman Shah , Jing Yang , Jean-Marie Ledeine , Michael J. Overman

Organizations

USC Norris Comprehensive Cancer Center, Los Angeles, CA, Veneto Institute of Oncology (IOV)-IRCCS, Padua, Italy, Oncologia Medica 1, Istituto Oncologico Veneto IRCCS Padova, Padua, Italy, University Hospitals Gasthuisberg Leuven, KU Leuven, Leuven, Belgium, Hospital Universitario Virgen del Rocío, Seville, Spain, Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, NSW, Australia, Gastrointestinal Unit, Department of Medical Oncology, Institut Jules Bordet-Université Libre de Bruxelles (ULB), Brussels, Belgium, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy, Hospital General Universitario Gregorio Marañón, Madrid, Spain, Department of Medical Oncology, Universitair Ziekenhuis Brussel, Brussels, Belgium, University Hospital of Modena, Modena, Italy, Vanderbilt-Ingram Cancer Center, Nashville, TN, Banner MD Anderson Cancer Center, Gilbert, AZ, Lehigh Valley Hospital, Allentown, PA, Imclone Syst/Eli Lilly, Bridgewater, NJ, Bristol-Myers Squibb, Brussels, Belgium, The University of Texas MD Anderson Cancer Center, Houston, TX

Research Funding

Pharmaceutical/Biotech Company
Bristol-Myers Squibb

Background: In the phase 2 CheckMate 142 trial, NIVO + low-dose IPI had robust, durable clinical benefit and was well tolerated as 1L therapy for MSI-H/dMMR mCRC (median follow-up 13.8 months [mo; range, 9–19]; Lenz et al. Ann Oncol 2018;29:LBA18). Longer follow-up is presented here. Methods: Patients (pts) with MSI-H/dMMR mCRC and no prior treatment for metastatic disease received NIVO 3 mg/kg Q2W + low-dose IPI 1 mg/kg Q6W until disease progression or discontinuation. The primary endpoint was investigator-assessed (INV) objective response rate (ORR) per RECIST v1.1. Results: In 45 pts with median follow-up of 29.0 mo, ORR (95% CI) increased to 69% (53–82) (Table) from 60% (44.3–74.3); complete response (CR) rate increased to 13% from 7%. The concordance rate of INV and blinded independent central review was 89%. Median duration of response (DOR) was not reached (Table). Median progression-free survival (PFS) and overall survival (OS) were not reached, and 24-mo rates were 74% and 79%, respectively (Table). Nineteen pts discontinued study treatment without subsequent therapy. An analysis of tumor response post discontinuation will be presented. Ten (22%) pts had grade 3–4 treatment-related adverse events (TRAEs); 3 (7%) had grade 3–4 TRAEs leading to discontinuation. Conclusions: NIVO + low-dose IPI continued to show robust, durable clinical benefit with a deepening of response, and was well tolerated with no new safety signals identified with longer follow-up. NIVO + low-dose IPI may represent a new 1L therapy option for pts with MSI-H/dMMR mCRC. Clinical trial information: NTC02060188.

Efficacy (INV)a.

NIVO + low-dose IPI (N = 45)
ORR,b n (%) [95% CI]31 (69) [53–82]
Best overall response, n (%)
CR6 (13)
PR25 (56)
SD7 (16)
PD6 (13)
Not determined1 (2)
Disease control rate,c n (%) [95% CI]38 (84) [70.5–93.5]
Median time to response (range), mo2.7 (1.2–27.7)
Median DOR (range), moNR (1.4+ to 29.0+)
Median PFS, mo (95% CI)NR (NE)
    24-mo rate, % (95% CI)74 (57.2–84.5)
Median OS, mo (95% CI)NR (NE)
    24-mo rate, % (95% CI)79 (64–89)

aMedian follow-up = time on study from first dose to data cutoff (29.0 mo [range, 24.2–33.7]).

bPts with CR or PR divided by number of treated pts.

cPts with CR, PR, or SD for ≥ 12 weeks divided by number of treated pts.

NE, not estimable; NR, not reached; PD, progressive disease; PR, partial response; SD, stable disease.

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Abstract Details

Meeting

2020 ASCO Virtual Scientific Program

Session Type

Poster Session

Session Title

Gastrointestinal Cancer—Colorectal and Anal

Track

Gastrointestinal Cancer—Colorectal and Anal

Sub Track

Colorectal Cancer–Advanced Disease

Clinical Trial Registration Number

NTC02060188

Citation

J Clin Oncol 38: 2020 (suppl; abstr 4040)

DOI

10.1200/JCO.2020.38.15_suppl.4040

Abstract #

4040

Poster Bd #

32

Abstract Disclosures