Opdivo Plus Yervoy Combination Demonstrated Superior Overall Survival and Showed Durable Responses in Patients with Previously Untreated Advanced or Metastatic Renal Cell Carcinoma in Phase 3 CheckMate -214 Trial
- Category: Antibodies
- Published on Monday, 11 September 2017 08:58
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Opdivo (nivolumab) plus Yervoy (ipilimumab) reduced the risk of death by 37% versus standard of care, sunitinib, in intermediate- and poor-risk patients
The combination also significantly improved overall survival in all randomized patients
Opdivo plus Yervoy demonstrated a 42% objective response rate in intermediate- and poor-risk patients, 9.4% were complete responses
Grade 3/4 adverse events experienced by 46% of patients in the Opdivo 3 mg/kg plus Yervoy 1 mg/kg combination arm and 64% in the sunitinib arm
PRINCETON, NJ, USA I September 10, 2017 I Bristol-Myers Squibb Company (NYSE:BMY) announced today results from the Phase 3 CheckMate -214 trial evaluating Opdivo (nivolumab) plus Yervoy (ipilimumab) versus sunitinib in patients with previously untreated advanced or metastatic renal cell carcinoma (RCC), including data on key subgroups. With a minimum follow-up of 17.5 months, Opdivo in combination with Yervoy reduced the risk of death 37% [HR 0.63; 99.8% CI: 0.44 to 0.89; P < 0.0001] compared with sunitinib, the current standard of care, in an interim analysis of overall survival (OS) in intermediate- and poor-risk patients, the co-primary endpoint. The median OS had not yet been reached for the combination and was 26 months for sunitinib (95% CI: 22.1 to NA). Results from CheckMate -214 will be presented today during Presidential Symposium II at the European Society for Medical Oncology (ESMO) 2017 Congress in Madrid, Spain, from 5:55-6:10 PM CEST in the Madrid Auditorium (Abstract #LBA5).
The Opdivo plus Yervoy combination also improved OS in all randomized patients, a secondary endpoint. In this population, the combination reduced the risk of death 32% [HR 0.68; 99.8% CI: 0.49 to 0.95; P=0.0003] compared with sunitinib. The median OS had not yet been reached for the combination and was 32.9 months for sunitinib (95% CI: NA to NA).
Results for objective response rate (ORR) and progression-free survival (PFS) in intermediate- and poor-risk patients, the two other co-primary endpoints, were previously reported. The safety of the combination was consistent with that observed in previously reported studies of these medicines in patients with RCC.
“There is an unmet need for additional treatment options in the first line setting that may provide a meaningful survival benefit including more durable, complete responses for patients with advanced renal cell carcinoma. These results for the combination of nivolumab and ipilimumab are very encouraging in patients with first-line mRCC who have a very poor prognosis,” said Bernard Escudier, M.D., former chair of the genitourinary group of the Institut Gustave Roussy in Villejuif, France.
Adverse events (AEs) leading to discontinuation were reported in 22% of patients (547) in the combination group, compared with 12% of patients in the sunitinib group (535). The most common grade 3/4 AEs in the combination group were fatigue (4%), diarrhea (4%), rash (2%), nausea (2%), and, in less than 1% each, pruritus, hypothyroidism, vomiting and hypertension. In the sunitinib group, the most common grade 3/4 AEs were hypertension (16%), fatigue (9%), Palmar-plantar erythrodysaesthesia syndrome (9%), stomatitis (3%), mucosal inflammation (3%), vomiting (2%), nausea (1%), decreased appetite (1%), hypothyroidism (<1%) and dysgeusia (<1%). There were seven treatment-related deaths in the combination group and four in the sunitinib group.
“As the pioneer in Immuno-Oncology research, we set a goal of increasing overall survival for more patients by combining agents and have now, for the second time in a phase 3 trial, demonstrated that the Opdivo plus Yervoy combination may provide a survival advantage for patients,” said Vicki Goodman, M.D., head of new asset development, Bristol-Myers Squibb. “These positive data showing the Opdivo plus Yervoy combination improved survival in the first-line setting offer the potential, pending regulatory approval, to change the standard of care in the first-line treatment of advanced RCC and may represent a significant step forward for patients with this disease.”
About CheckMate -214
CheckMate -214 is a phase 3, randomized, open-label study evaluating the combination of Opdivo plus Yervoy versus sunitinib in patients with previously untreated advanced or metastatic renal cell carcinoma. Patients in the combination group received Opdivo 3 mg/kg plus Yervoy 1 mg/kg every 3 weeks for 4 doses followed by Opdivo 3 mg/kg every 2 weeks. Patients in the comparator group received sunitinib 50 mg once daily for 4 weeks, followed by 2 weeks off before continuation of treatment. Patients were treated until progression or unacceptable toxic effects. The primary endpoints of the trial are progression-free survival (PFS), overall survival (OS) and objective response rate (ORR) in an intermediate to poor-risk patient population (approximately 75% of patients). The majority of alpha was allocated to overall survival. Safety is a secondary endpoint.
The company previously reported that the combination of Opdivo plus Yervoy achieved an ORR of 42% versus 27% for sunitinib in poor- and intermediate-risk patients, a co-primary endpoint. Median duration of response was not reached for the combination and was 18.2 months for sunitinib. PFS in intermediate- and poor-risk patients, a co-primary endpoint, improved 18% for those receiving the combination (HR 0.82; 99.1% CI: 0.64 to 1.05; stratified two-sided p=0.0331) but did not reach the pre-defined statistical significance threshold of 0.009 compared with sunitinib. The median PFS for the combination group was 11.6 months (95% CI: 8.7 to 15.5) versus 8.4 months (95% CI: 7.0 to 10.8) for the sunitinib group.
About Renal Cell Carcinoma
Renal cell carcinoma (RCC) is the most common type of kidney cancer in adults, accounting for more than 100,000 deaths worldwide each year. Clear-cell RCC is the most prevalent type of RCC and constitutes 80% to 90% of all patients. RCC is approximately twice as common in men as in women, with the highest rates of the disease in North America and Europe. Globally, the five-year survival rate for those diagnosed with metastatic, or advanced, kidney cancer is 12.1%.
Bristol-Myers Squibb & Immuno-Oncology: Advancing Oncology Research
At Bristol-Myers Squibb, patients are at the center of everything we do. Our vision for the future of cancer care is focused on researching and developing transformational Immuno-Oncology (I-O) medicines for hard-to-treat cancers that could potentially improve outcomes for these patients.
We are leading the scientific understanding of I-O through our extensive portfolio of investigational compounds and approved agents. Our differentiated clinical development program is studying broad patient populations across more than 50 types of cancers with 14 clinical-stage molecules designed to target different immune system pathways. Our deep expertise and innovative clinical trial designs position us to advance I-O/I-O, I-O/chemotherapy, I-O/targeted therapies and I-O radiation therapies across multiple tumors and potentially deliver the next wave of therapies with a sense of urgency. We also continue to pioneer research that will help facilitate a deeper understanding of the role of immune biomarkers and how patients’ tumor biology can be used as a guide for treatment decisions throughout their journey.
We understand making the promise of I-O a reality for the many patients who may benefit from these therapies requires not only innovation on our part but also close collaboration with leading experts in the field. Our partnerships with academia, government, advocacy and biotech companies support our collective goal of providing new treatment options to advance the standards of clinical practice.
Opdivo is a programmed death-1 (PD-1) immune checkpoint inhibitor that is designed to uniquely harness the body’s own immune system to help restore anti-tumor immune response. By harnessing the body’s own immune system to fight cancer, Opdivo has become an important treatment option across multiple cancers.
Opdivo’s leading global development program is based on Bristol-Myers Squibb’s scientific expertise in the field of Immuno-Oncology and includes a broad range of clinical trials across all phases, including Phase 3, in a variety of tumor types. To date, the Opdivo clinical development program has enrolled more than 25,000 patients. The Opdivo trials have contributed to gaining a deeper understanding of the potential role of biomarkers in patient care, particularly regarding how patients may benefit from Opdivo across the continuum of PD-L1 expression.
In July 2014, Opdivo was the first PD-1 immune checkpoint inhibitor to receive regulatory approval anywhere in the world. Opdivo is currently approved in more than 60 countries, including the United States, the European Union and Japan. In October 2015, the company’s Opdivo and Yervoy combination regimen was the first Immuno-Oncology combination to receive regulatory approval for the treatment of metastatic melanoma and is currently approved in more than 50 countries, including the United States and the European Union.
U.S. FDA-APPROVED INDICATIONS FOR OPDIVO ®
OPDIVO® (nivolumab) as a single agent is indicated for the treatment of patients with BRAF V600 mutation-positive unresectable or metastatic melanoma. This indication is approved under accelerated approval based on progression-free survival. Continued approval for this indication may be contingent upon verification and description of clinical benefit in the confirmatory trials
OPDIVO® (nivolumab) as a single agent is indicated for the treatment of patients with BRAF V600 wild-type unresectable or metastatic melanoma.
OPDIVO® (nivolumab), in combination with YERVOY® (ipilimumab), is indicated for the treatment of patients with unresectable or metastatic melanoma. This indication is approved under accelerated approval based on progression-free survival. Continued approval for this indication may be contingent upon verification and description of clinical benefit in the confirmatory trials.
OPDIVO® (nivolumab) is indicated for the treatment of patients with metastatic non-small cell lung cancer (NSCLC) with progression on or after platinum-based chemotherapy. Patients with EGFR or ALK genomic tumor aberrations should have disease progression on FDA-approved therapy for these aberrations prior to receiving OPDIVO.
OPDIVO® (nivolumab) is indicated for the treatment of patients with advanced renal cell carcinoma (RCC) who have received prior anti-angiogenic therapy.
OPDIVO® (nivolumab) is indicated for the treatment of adult patients with classical Hodgkin lymphoma (cHL) that has relapsed or progressed after autologous hematopoietic stem cell transplantation (HSCT) and brentuximab vedotin or after 3 or more lines of systemic therapy that includes autologous HSCT. This indication is approved under accelerated approval based on overall response rate. Continued approval for this indication may be contingent upon verification and description of clinical benefit in confirmatory trials.
OPDIVO® (nivolumab) is indicated for the treatment of patients with recurrent or metastatic squamous cell carcinoma of the head and neck (SCCHN) with disease progression on or after platinum-based therapy.
OPDIVO® (nivolumab) is indicated for the treatment of patients with locally advanced or metastatic urothelial carcinoma who have disease progression during or following platinum-containing chemotherapy or have disease progression within 12 months of neoadjuvant or adjuvant treatment with platinum-containing chemotherapy. This indication is approved under accelerated approval based on tumor response rate and duration of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in confirmatory trials.
OPDIVO® (nivolumab) is indicated for the treatment of adults and pediatric (12 years and older) patients with microsatellite instability high (MSI-H) or mismatch repair deficient (dMMR) metastatic colorectal cancer (CRC) that has progressed following treatment with a fluoropyrimidine, oxaliplatin, and irinotecan. This indication is approved under accelerated approval based on overall response rate and duration of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in confirmatory trials.
Checkmate Trials and Patient Populations
Checkmate 067 - advanced melanoma alone or in combination with YERVOY; Checkmate 037 and 066 - advanced melanoma; Checkmate 017 - squamous non-small cell lung cancer (NSCLC); Checkmate 057 - non-squamous NSCLC; Checkmate 025 - renal cell carcinoma; Checkmate 205/039 - classical Hodgkin lymphoma; Checkmate 141 - squamous cell carcinoma of the head and neck; Checkmate 275 - urothelial carcinoma.
About the Bristol-Myers Squibb and Ono Pharmaceutical Co., Ltd. Collaboration
In 2011, through a collaboration agreement with Ono Pharmaceutical Co., Ltd (Ono), Bristol-Myers Squibb expanded its territorial rights to develop and commercialize Opdivo globally except in Japan, South Korea and Taiwan, where Ono had retained all rights to the compound at the time. On July 23, 2014, Bristol-Myers Squibb and Ono further expanded the companies’ strategic collaboration agreement to jointly develop and commercialize multiple immunotherapies – as single agents and combination regimens – for patients with cancer in Japan, South Korea and Taiwan.
About Bristol-Myers Squibb
Bristol-Myers Squibb is a global biopharmaceutical company whose mission is to discover, develop and deliver innovative medicines that help patients prevail over serious diseases. For more information about Bristol-Myers Squibb, visit us at BMS.com or follow us on LinkedIn, Twitter, YouTube and Facebook.
SOURCE: Bristol-Myers Squibb