Abstract 1512
Background
NIVO (a PD-1 checkpoint inhibitor) and IPI (a CTLA-4 checkpoint inhibitor) are now approved in several countries including US, EU and Japan for the treatment of advanced melanoma (MEL). A phase 3 study (CheckMate -067) in previously untreated patients (pts), compare the PFS and OS of nivolumab monotherapy to ipilimumab monotherapy and that of nivolumab combined with ipilimumab to ipilimumab monotherapy. Here, we report the latest analysis of the efficacy (ORR, OS, PFS, DOR) and safety of combination therapy with NIVO and IPI in previously untreated Japanese MEL pts.
Methods
A phase 2 single arm- study (ONO-4538-17) enrolled Japanese pts aged ≥ 20 years with ECOG PS 0/1 and stage IIIB/IV/recurrent MEL. NIVO (1 mg/kg IV) plus IPI(3mg/kg IV) Q3W for 4 doses then NIVO 3mg/kg Q2W was given to pts until PD, CR or unacceptable toxicity. The primary endpoint was ORR, and secondary endpoints included PFS, OS, DOR and safety. Clinical responses were evaluated by the independent investigator as per RECIST v1.1, including pts with BRAF V600 mutations.
Results
30 MEL pts received NIVO and IPI combination therapy in this study. As previously reported, baseline patient characteristics were similar to other clinical trials and included pts with a median age of 58.5, ECOG PS 1 in 3 pts (10%), and 2 pts (6.7%) were BRAF mutation positive. ORR was 43.3% (95%CI: 25.5 - 62.6). All pts experienced drug-related AEs. Grade 3-4 drug-related AEs were seen in 24 pts (80.0%) and 9 pts (30.0%) discontinued study therapy due to the AEs. Despite these high rates, these AEs were manageable and the drug-related deaths have not been reported. Response rates by subgroup analysis by BRAF status were similar for BRAF wild type and BRAF mutants, respectively.
Conclusions
NIVO and IPI combination therapy showed positive results of ORR in Japanese MEL pts, with results consistent with the larger phase 3 trials (CheckMate-067). The efficacy was verified regardless of BRAF status. The safety profile had no new signal compared to earlier reports.
Clinical trial identification
JAPIC-CTI #142533 (May 9, 2014).
Legal entity responsible for the study
ONO Pharmaceutical, Bristol-Myers Squibb
Funding
ONO Pharmaceutical, Bristol-Myers Squibb
Disclosure
Y. Kiyohara: Honoraria was received from ONO Pharmaceutical, Chugai Pharmaceutical, MSD, Bristol-Myers Squibb. Research funding was received from ONO Pharmaceutical, Chugai Pharmaceutical, Bristol-Myers Squibb, MSD, GlaxoSmithKline, Novartis Pharma. T. Takenouchi: Honoraria was received form ONO Pharmaceutical, Chugai Pharmaceutical. H. Uhara: Honoraria was received from ONO Pharmaceutical, Bristol-Myers Squibb, Chugai Pharmaceutical, N. Yamazaki: Honoraria was received from ONO Pharmaceutical, Bristol-Myers Squibb, Novartis Pharma., MSD K, K. Research funding was received from ONO Pharmaceutical, Bristol-Myers Squibb, Novartis Pharma, MSD K, K.
All other authors have declared no conflicts of interest.