Five-year overall survival from the anti-PD1 brain collaboration (ABC Study): Randomized phase 2 study of nivolumab (nivo) or nivo+ipilimumab (ipi) in patients (pts) with melanoma brain metastases (mets).

Authors

Georgina Long

Georgina V. Long

Melanoma Institute Australia, University of Sydney, and Royal North Shore and Mater Hospitals, Sydney, Australia

Georgina V. Long , Victoria Atkinson , Serigne Lo , Alexander David Guminski , Shahneen Kaur Sandhu , Michael Paul Brown , Maria Gonzalez , Richard A. Scolyer , Louise Emmett , Grant A. McArthur , Alexander M. Menzies

Organizations

Melanoma Institute Australia, University of Sydney, and Royal North Shore and Mater Hospitals, Sydney, Australia, Princess Alexandra Hospital, University of Queensland, Greenslopes, Brisbane, QLD, Australia, Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia, Royal North Shore Hospital, Sydney, Australia, Peter MacCallum Cancer Center, Melbourne, VIC, Australia, Royal Adelaide Hospital, Adelaide, Australia, Melanoma Institute Australia, Sydney, Australia, Melanoma Institute Australia, The University of Sydney, Sydney, Australia, St Vincent’s Clinic Medical Imaging and Nuclear Medicine, Darlinghurst, Australia, Melanoma and Skin Service and Cancer Therapeutics Program, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia, Melanoma Institute Australia, The University of Sydney, and Royal North Shore and Mater Hospitals, Sydney, NSW, Australia

Research Funding

Pharmaceutical/Biotech Company
BMS, Other Foundation

Background: Preliminary data from the ABC (76 pts) and CheckMate 204 (94 pts) trials showed that nivo and nivo+ipi have activity in active melanoma brain metastases, with durable responses in a subset of pts. Here, we report updated 5-yr data from all pts enrolled on the ABC trial (NCT02374242). Methods: This open-label ph2 trial enrolled 3 cohorts of pts with active melanoma brain mets naïve to anti-PD1/PDL1/PDL2/CTLA4 from Nov 2014-Apr 2017. Pts with asymptomatic brain mets with no prior local brain therapy were randomised to cohort A (nivo 1mg/kg + ipi 3mg/kg, Q3Wx4, then nivo 3mg/kg Q2W) or cohort B (nivo 3mg/kg Q2W). Cohort C (nivo 3mg/kg Q2W) had brain mets i) that failed local therapy, ii) with neuro symptoms and/or iii) with leptomeningeal disease. Prior BRAF inhibitor (BRAFi) was allowed. The primary endpoint was best intracranial response (ICR) ≥wk12. Key secondary endpoints were IC PFS, overall PFS, OS, & safety. Results: A total of 76 pts (med f/u 54 mo) were enrolled; median age 59y, 78% male. For cohorts A, B and C: elevated LDH 51%, 58% and 19%; V600BRAF 54%, 56% and 81%; prior BRAFi 23%, 24%, 75%. Efficacy and toxicity are shown in the table. There were no treatment-related deaths. 1/17 deaths in cohort A & 4/16 in cohort B were due to IC progression only. Conclusions: Nivo monotherapy and ipi+nivo are active in melanoma brain mets, with durable responses in the majority of patients who received ipi+nivo upfront. A study of upfront ipi+nivo+/-SRS is underway (NCT03340129).Clinical trial information: NCT02374242


A (ipi+nivo)
B (nivo)
C (nivo)
All patients
n=35
n=25
n=16
ICR
51%
20%
6%
5-yr IC PFS
46%
15%
6%
5-yr OS
51%
34%
13%
Rx naïve
n=27
n=19
n=4
ICR (Rx naïve)
59%
21%
25%
5-yr IC PFS (Rx naïve)
52%
14%
.
5-yr OS (Rx naïve)
55%
40%
25%
TRAE G3/4
63%
20%
13%

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Abstract Details

Meeting

2021 ASCO Annual Meeting

Session Type

Oral Abstract Session

Session Title

Melanoma/Skin Cancers

Track

Melanoma/Skin Cancers

Sub Track

Advanced/Metastatic Disease

Clinical Trial Registration Number

NCT02374242

Citation

J Clin Oncol 39, 2021 (suppl 15; abstr 9508)

DOI

10.1200/JCO.2021.39.15_suppl.9508

Abstract #

9508

Abstract Disclosures