Nivolumab (NIVO) plus (+) chemotherapy (chemo) or ipilimumab (IPI) vs chemo as 1L treatment for advanced esophageal squamous cell carcinoma (ESCC): First comprehensive biomarker analyses from CheckMate 648.

Authors

null

Ming Lei

Bristol Myers Squibb, Princeton, NJ

Ming Lei , Yuichiro Doki , Yuko Kitagawa , Ken Kato , Ian Chau , Jin Yao , Jianming Xu , Lucjan S. Wyrwicz , Satoru Motoyama , Takashi Ogata , Hisato Kawakami , Chih-Hung Hsu , Antoine Adenis , Farid El Hajbi , Maria Di Bartolomeo , Maria Ignez Braghiroli , Eva Holtved , Mariela A. Blum Murphy , Ruslan Novosiadly , Jaffer A. Ajani

Organizations

Bristol Myers Squibb, Princeton, NJ, Osaka University Graduate School of Medicine, Osaka, Japan, Keio University School of Medicine, Tokyo, Japan, National Cancer Center Hospital, Tokyo, Japan, The Royal Marsden NHS Foundation Trust, London, United Kingdom, Department of Gastrointestinal Oncology, The Fifth Medical Center, Chinese PLA General Hospital, Beijing, China, Klinika Onkologii i Radioterapii, Narodowy Instytut Onkologii, Warszawa, Poland, Akita University Hospital, Akita, Japan, Kanagawa Cancer Center, Kanagawa, Japan, Kindai University Faculty of Medicine, Osakasayama, Japan, National Taiwan University Hospital, Taipei, Taiwan, Institut du Cancer de Montpellier, Montpellier, France, Centre Oscar Lambret, Lille, France, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy, Institute of Cancer of São Paulo, University of São Paulo, São Paulo, Brazil, Odense University Hospital, Odense, Denmark, The University of Texas MD Anderson Cancer Center, Houston, TX

Research Funding

Bristol Myers Squibb

Background: NIVO + chemo and NIVO + IPI demonstrated superior overall survival (OS) vs chemo in previously untreated patients with advanced ESCC in CheckMate 648 (NCT03143153), resulting in approvals in many countries. We present first comprehensive exploratory biomarker analysis results from this trial. Methods: Whole exome sequencing (WES) of baseline tumor tissue and matching blood was performed to assess tumor mutational burden (TMB) and select gene alterations. TMB-high tumors were defined as ≥ 199 mutations/exome. RNA sequencing of baseline tumor tissue was used to assess gene expression signatures (GES). GES subgroups were defined by signature score tertiles. Results: In total, 60% (191/321) of patients receiving NIVO + chemo were both WES- and GES-evaluable; 62% (200/325) and 58% (188/325) of patients receiving NIVO + IPI and 59% (190/324) and 59% (192/324) receiving chemo were WES- and GES-evaluable, respectively. In the NIVO + chemo arm, patients with TMB-high tumors had numerically longer median OS (mOS) compared with TMB-low tumors, whereas mOS was similar between TMB subgroups treated with NIVO + IPI, although the number of patients with TMB-high tumors was small (Table). Higher inflammation and lower β-catenin GES scores were associated with improved OS benefit of NIVO + chemo or IPI vs chemo (Table). Lower fibroblast GES scores were associated with improved OS benefit of NIVO + IPI vs chemo (Table). Additional biomarker analyses, including select gene alterations and GES in tumor cell PD-L1 subgroups, will be presented. Conclusions: These results further support the clinical efficacy of NIVO + chemo and NIVO + IPI in 1L ESCC and suggest enhanced OS benefit in multiple biomarker subgroups. The clinical utility of these biomarkers should be validated in future trials. Clinical trial information: NCT03143153.

nMedian OSUnstratified HR (95% CI)nMedian OSUnstratified HR (95% CI)
NIVO + chemoChemoNIVO + IPIChemo
All TMB-evaluable38114.410.10.80 (0.64, 1.00)39015.110.10.75 (0.60, 0.95)
TMB-high3223.813.10.67 (0.28, 1.63)2215.713.11.20 (0.46, 3.14)
TMB-low34914.010.20.80 (0.66, 1.05)36815.110.20.73 (0.58, 0.93)
All GES-evaluable38315.59.50.75 (0.60, 0.94)38013.99.50.72 (0.57, 0.91)
Inflammatory
 High12822.012.60.63 (0.41, 0.96)12723.112.10.58 (0.37, 0.90)
 Med12712.58.60.68 (0.46, 0.98)12616.28.60.59 (0.40, 0.87)
 Low12813.49.60.98 (0.66, 1.43)1279.79.61.05 (0.71, 1.54)
β-catenin
 High12811.19.91.05 (0.72, 1.54)12713.59.90.73 (0.49, 1.08)
 Med12719.110.20.64 (0.42, 0.97)12610.910.70.97 (0.65, 1.44)
 Low12815.89.10.60 (0.41, 0.89)12718.39.10.50 (0.33, 0.76)
Fibroblast
 High12814.011.90.84 (0.57, 1.24)12711.311.70.98 (0.65, 1.46)
 Med12715.78.80.64 (0.43, 0.95)12617.28.60.56 (0.37, 0.85)
 Low12815.89.40.76 (0.51, 1.12)12719.39.30.70 (0.47, 1.05)

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Abstract Details

Meeting

2024 ASCO Gastrointestinal Cancers Symposium

Session Type

Rapid Oral Abstract Session

Session Title

Rapid Oral Abstract Session A: Cancers of the Esophagus and Stomach

Track

Esophageal and Gastric Cancer,Other GI Cancer

Sub Track

Tumor Biology, Biomarkers, and Pathology

Clinical Trial Registration Number

NCT03143153

Citation

J Clin Oncol 42, 2024 (suppl 3; abstr 252)

DOI

10.1200/JCO.2024.42.3_suppl.252

Abstract #

252

Abstract Disclosures