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
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% |
Disclaimer
This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org
Abstract Disclosures
2023 ASCO Annual Meeting
First Author: Suzanne Phillips
2017 ASCO Annual Meeting
First Author: Georgina V. Long
2023 ASCO Annual Meeting
First Author: Dirk Schadendorf
2015 ASCO Annual Meeting
First Author: Kim Allyson Margolin