Adjuvant nivolumab (NIVO) in resected esophageal or gastroesophageal junction cancer (EC/GEJC) following neoadjuvant chemoradiotherapy (CRT): Expanded efficacy and safety analyses from CheckMate 577.

Authors

Ronan Kelly

Ronan Joseph Kelly

The Charles A. Sammons Cancer Center, Baylor University Medical Center, Dallas, TX

Ronan Joseph Kelly , Jaffer A. Ajani , Jaroslaw Kuzdzal , Thomas Zander , Eric Van Cutsem , Guillaume Piessen , Guillermo Mendez , Josephine Louella Feliciano , Satoru Motoyama , Astrid Lièvre , Hope Elizabeth Uronis , Elena Elimova , Cecile Grootscholten , Karen Paula Geboes , Jenny Zhang , Samira Soleymani , Ming Lei , Prianka Singh , James M. Cleary , Markus H. Moehler

Organizations

The Charles A. Sammons Cancer Center, Baylor University Medical Center, Dallas, TX, The University of Texas MD Anderson Cancer Center, Houston, TX, Jagiellonian University, John Paul II Hospital, Krakow, Poland, University Hospital of Cologne, Cologne, Germany, University Hospitals Gasthuisberg, Leuven and KULeuven, Leuven, Belgium, University of Lille, Claude Huriez University Hospital, Lille, France, Fundacion Favaloro, Buenos Aires, Argentina, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, Akita University Hospital, Akita, Japan, CHU Pontchaillou, Rennes 1 University, Rennes, France, Duke Cancer Institute, Durham, NC, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands, UZ Gent, Gent, Belgium, Bristol Myers Squibb, Princeton, NJ, Dana Farber Cancer Institute, Boston, MA, Johannes-Gutenberg University Clinic, Mainz, Germany

Research Funding

Pharmaceutical/Biotech Company
Bristol Myers Squibb

Background: In CheckMate 577 (NCT02743494), NIVO demonstrated a significant and clinically meaningful improvement in disease-free survival (DFS; primary endpoint) vs placebo (PBO) and was well tolerated in patients (pts) with resected (R0) stage II/III EC/GEJC who received neoadjuvant CRT and had residual pathologic disease. Median DFS doubled with NIVO vs PBO (22.4 vs 11.0 months; HR 0.69; 96.4% CI 0.56–0.86; P = 0.0003). Serious treatment-related adverse events (TRAEs) and TRAEs leading to discontinuation were reported for < 10% of pts with NIVO and 3% with PBO. Methods: Pts were randomized 2:1 to NIVO 240 mg or PBO Q2W for 16 weeks, followed by NIVO 480 mg or PBO Q4W. Here, we present additional efficacy, safety, and quality-of-life (QoL) data from CheckMate 577. Results: 794 pts were randomized (NIVO, 532; PBO, 262). Distant recurrence was reported for 29% vs 39% and locoregional recurrence for 12% vs 17% of pts in the NIVO vs PBO groups, respectively. Median distant metastasis-free survival was 28.3 vs 17.6 months with NIVO vs PBO (HR 0.74; 95% CI 0.60–0.92). Median progression-free survival 2 (PFS2; time from randomization to progression after subsequent systemic therapy, initiation of second subsequent systemic therapy, or death, whichever is earlier) was not reached with NIVO vs 32.1 months with PBO (HR 0.77; 95% CI 0.60–0.99). TRAEs with potential immunologic etiology (select TRAEs; sTRAEs) reported for NIVO are presented in the table. Results for the FACT-ECS and FACT-G7 showed similar trends for QoL improvement from baseline for NIVO and PBO during treatment and maintained benefit post-treatment. Conclusions: Adjuvant NIVO demonstrated clinically meaningful efficacy, an acceptable safety profile, and maintained QoL, providing further support for its use as a new standard of care for pts with resected EC/GEJC who received neoadjuvant CRT with residual pathologic disease. Clinical trial information: NCT02743494

TRAEs with potential immunologic etiology in the NIVO group (n = 532).

Pts with any grade sTRAEs,a n (%)
Median time to onset (range), weeks
Median time to resolution (range),b weeks
Pts receiving immune-modulating medication, n (%)
Pts with resolution of sTRAEs,b n (%)
Endocrine
93 (17)
9.7 (1.7–52.4)
21.1 (2.0–150.0+)
10 (11)
62 (67)
Gastrointestinal
91 (17)
7.4 (0.1–49.3)
3.5 (0.1–84.1+)
9 (10)
83 (94)
Hepatic
49 (9)
6.1 (1.1–49.3)
7.6 (0.4+ to 126.4+)
7 (14)
37 (80)
Pulmonary
23 (4)
12.7 (4.0–47.9)
5.9 (0.7–65.0)
17 (74)
17 (74)
Renal
7 (1)
12.1 (1.9–37.1)
2.6 (0.7–17.0)
2 (29)
6 (100)
Skin
130 (24)
6.1 (0.1–49.0)
17.9 (0.1–163.1+)
50 (38)
85 (65)

aMost sTRAEs were grade 1 or 2. Grade 3–4 sTRAEs occurred in ≤ 1% of pts and there were no grade 5 sTRAEs. bEvents without a stop date or where stop date was death date were considered unresolved; events without worsening from baseline were excluded.

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Abstract Details

Meeting

2021 ASCO Annual Meeting

Session Type

Oral Abstract Session

Session Title

Gastrointestinal Cancer—Gastroesophageal, Pancreatic, and Hepatobiliary

Track

Gastrointestinal Cancer—Gastroesophageal, Pancreatic, and Hepatobiliary

Sub Track

Esophageal or Gastric Cancer

Clinical Trial Registration Number

NCT02743494

Citation

J Clin Oncol 39, 2021 (suppl 15; abstr 4003)

DOI

10.1200/JCO.2021.39.15_suppl.4003

Abstract #

4003

Abstract Disclosures