Nivolumab (NIVO) + relatlimab (RELA) versus NIVO in previously untreated metastatic or unresectable melanoma: OS and ORR by key subgroups from RELATIVITY-047.

Authors

Hussein Tawbi

Hussein A. Tawbi

The University of Texas MD Anderson Cancer Center, Houston, TX

Hussein A. Tawbi , F. Stephen Hodi , Evan J. Lipson , Dirk Schadendorf , Paolo Antonio Ascierto , Luis Matamala , Pamela Salman , Erika Castillo Gutiérrez , Piotr Rutkowski , Helen Gogas , Christopher D. Lao , Juliana Janoski De Menezes , Stéphane Dalle , Ana Maria Arance , Jean-Jacques Grob , Sarah Keidel , Karin Jonczak , Anne Marie Sobiesk , Sonia Dolfi , Georgina V. Long

Organizations

The University of Texas MD Anderson Cancer Center, Houston, TX, Dana-Farber Cancer Institute, Boston, MA, Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, Department of Dermatology, University Hospital Essen & German Cancer Consortium, Partner Site, Essen, Germany, Istituto Nazionale Tumori IRCCS Fondazione "G. Pascale", Naples, Italy, Department of Oncology, Instituto Oncologico Fundacion Arturo Lopez Perez and Department of Oncology, Instituto Nacional del Cancer, Santiago, Chile, Department of Oncology, Instituto Oncologico Fundacion Arturo Lopez Perez, Santiago, Chile, FAICIC Clinical Research, Veracruz, Mexico, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland, Department of Medicine, National and Kapodistrian University of Athens, Athens, Greece, Michigan Medicine, Rogel Cancer Center, University of Michigan, Ann Arbor, MI, Hospital Nossa Senhora da Conceição, Porto Alegre, Brazil, Unit of Dermatology, Hospices Civils de Lyon, Cancer Research Center of Lyon, Pierre-Bénite, France, Department of Medical Oncology, Hospital Clinic Barcelona and IDIBAPS, Barcelona, Spain, Aix-Marseille University, CHU Timone, Marseille, France, Bristol Myers Squibb, Princeton, NJ, Melanoma Institute Australia, The University of Sydney, Royal North Shore and Mater Hospitals, Sydney, NSW, Australia

Research Funding

Pharmaceutical/Biotech Company

Background: In the phase 2/3 RELATIVITY-047 trial, NIVO + RELA as a fixed-dose combination (FDC) significantly improved the primary endpoint of progression-free survival (PFS) versus NIVO in patients (pts) with previously untreated metastatic or unresectable melanoma. Secondary endpoints showed a clinically meaningful improvement in overall survival (OS), although not statistically significant, and a higher objective response rate (ORR). As previously reported, PFS and OS favored NIVO + RELA over NIVO across prespecified stratification factors (LAG-3 expression, PD-L1 expression, BRAF V600 mutation status, and metastasis stage). Here we report the first disclosure of ORR analyzed by prespecified stratification factors and OS and ORR in additional subgroups. Methods: Pts were randomized 1:1 to receive NIVO 480 mg + RELA 160 mg FDC or NIVO 480 mg intravenously Q4W. The primary endpoint was PFS per RECIST v1.1 assessed by blinded independent central review (BICR). Secondary endpoints were OS and ORR by BICR, tested in hierarchy. Exploratory analyses were performed for PFS, OS, and ORR by prespecified subgroups. Results: PFS continued to favor NIVO + RELA over NIVO across key subgroups. OS and ORR also favored NIVO + RELA over NIVO across key subgroups including those associated with poor prognosis (Table). ORR favored NIVO + RELA over NIVO for pts with LAG-3 expression ≥ 1% (47% vs 35%) and < 1% (31% vs 24%), PD-L1 expression ≥ 1% (53% vs 45%) and < 1% (36% vs 24%), and BRAF wild-type (43% vs 34%) and mutant (43% vs 31%) melanoma, respectively. Additional key prespecified subgroups will be presented. In all treated pts, NIVO + RELA maintained a manageable safety profile with no new or unexpected safety signals. Conclusions: NIVO + RELA was favored over NIVO across key subgroups for PFS, OS, and ORR, and findings appeared consistent with outcomes in the overall population. NIVO + RELA had a favorable benefit-risk profile. Clinical trial information: NCT03470922.


Patients, n
mOS, months (95% CI)
ORR, % (95% exact CI)
Subgroup
N+R
N
N+R
N
Unstratified HR (95% CI)
N+R
N
Overall
355
359
NR
34 (25.2–NR)
0.81 (0.64–1.01)
43 (37.9–48.4)
33 (27.8–37.7)
Metastasis stage M1c*
151
127
34 (17.9–NR)
22 (13.8–33.2)
0.78 (0.56–1.08)
37 (29.4–45.3)
29 (21.4–37.9)
High tumor burden (≥ Q3)
84
75
17 (10.8–34.0)
9 (6.2–19.1)
0.75 (0.51–1.11)
32 (22.4–43.2)
23 (13.8–33.8)
LDH ≤ ULN
225
231
NR
NR
0.76 (0.55–1.06)
50 (43.1–56.5)
35 (28.5–41.2)
LDH > ULN
129
128
17 (10.8–31.5)
14 (9.7–21.0)
0.81 (0.59–1.11)
32 (23.9–40.6)
29 (21.2–37.6)

CI, confidence interval; HR, hazard ratio; LDH, lactate dehydrogenase; mOS, median overall survival; NR, not reached; N, nivolumab; N+R, nivolumab plus relatlimab; n, number of patients; Q3, quartile 3; R, relatlimab; ULN, upper limit of normal. *AJCC v8; Tumor burden quartile as determined by BICR at baseline; ̂Unstratified HR was 0.81 and stratified HR was 0.80.

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Abstract Details

Meeting

2022 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

NCT03470922

Citation

J Clin Oncol 40, 2022 (suppl 16; abstr 9505)

DOI

10.1200/JCO.2022.40.16_suppl.9505

Abstract #

9505

Abstract Disclosures