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Mini Oral - Head & neck cancer

917MO - TOPNIVO - A safety study of nivolumab in patients with recurrent and/or metastatic platinum-refractory squamous cell carcinoma of head and neck (R/M SCCHN): Final analysis

Date

18 Sep 2020

Session

Mini Oral - Head & neck cancer

Presenters

Caroline Even

Citation

Annals of Oncology (2020) 31 (suppl_4): S599-S628. 10.1016/annonc/annonc277

Authors

C. Even1, A. Daste2, J. Fayette3, G. Lefebvre4, E. Saada-Bouzid5, S. Zanetta6, C. Toullec7, D. Cupissol8, S. Salas9, M.C. Kaminski10, A.C. Johnson11, E. Vauleon12, C. Le Tourneau13, C. Sire14, A. Prevost15, I. Jallut16, J. Bourhis17, J. Guigay18, A. Aupérin19, M. Texier20

Author affiliations

  • 1 Département De Carcinologie Cervicofaciale, Institut Gustave Roussy, 94800 - Villejuif/FR
  • 2 Gironde, CHU Bordeaux Hopital St. André, 33000 - Bordeaux/FR
  • 3 Medicine, Centre Léon Bérard, 69008 - Lyon/FR
  • 4 Head & Neck / Thoracic Oncology, Oscar Lambret Center, 59020 - Lille/FR
  • 5 Medical Oncology, Centre Anticancer Antoine Lacassagne, Marseille/FR
  • 6 Medical Oncology Department, Centre Georges-François Leclerc (Dijon), 21000 - Dijon/FR
  • 7 Digestive Oncology, Institut Sainte Catherine, 84819 - Avignon/FR
  • 8 Medecine, Val d'Aurelle, 34298 - Montpellier/FR
  • 9 Medical Oncology, Ap-hm, 13005 - Marseille/FR
  • 10 Medical Oncology, Institut de Cancérologie de Lorraine, 54519 - Vandoeuvre Les Nancy/FR
  • 11 Breast / Head And Neck, Centre Francois Baclesse, 14076 - Caen/FR
  • 12 Medical Oncology, Centre Eugene - Marquis, 35042 - Rennes/FR
  • 13 Department Of Drug Development And Innovation (d3i), Institut Curie, 75248 - Paris/FR
  • 14 Lorient, CHU Bretagne Sud, 56322 - Lorient/FR
  • 15 Medical Oncology, Institut Jean Godinot, 51100 - Reims/FR
  • 16 Head And Neck Group, Unicancer, 75654 - Paris/FR
  • 17 Radiation Oncology, CHUV - Centre Hospitalier Universitaire Vaudois, 1011 - Lausanne/CH
  • 18 Medical Oncology Department, Centre Anticancer Antoine Lacassagne, 06189 - Nice/FR
  • 19 Department Of Biostatistics And Epidemiology - Team Oncostat, Cesp U1018 Inserm, University Paris-saclay, Institut Gustave Roussy, 94805 - Villejuif/FR
  • 20 Biostatistics, Institut Gustave Roussy, 94805 - Villejuif/FR
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Resources

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Abstract 917MO

Background

In the randomized phase III Study CA209141, Nivolumab (N) demonstrated significant overall survival (OS) benefit with favorable safety profile for platinum refractory R/M SCCHN and is now approved for these patients (pts). The objectives of the current study were to provide additional insights into the frequency of high-grade adverse events (AEs) related to N and the efficacy of N in real life.

Methods

From 08/2017 to 11/2018, 343 pts were treated in the multicenter phase II TOPNIVO. The main inclusion criteria were pts with platinum refractory R/M SCCHN, ECOG 0-2. Pts received N 3mg/kg every 2 weeks intravenously. We report safety and efficacy (OS, progression free survival (PFS), overall response rate (ORR)).

Results

Median age was 62 yr (73 pts ≥ 70 yr), 81% male, 85% ECOG 0-1, 15% ECOG 2. Cancer primary site was oropharynx 40%, oral cavity 24%, hypopharynx 20%, larynx 15%. 37% had loco regional (LR) relapse, 30% metastatic disease and 33% both. 51% had received one prior line of chemotherapy and 27% two prior lines before inclusion. Median number of N administrations was 6 (from 1 to 63). 233 pts (68%) experienced ≥ 1 AE grade ≥3. On the 434 AEs grade 3-4, 53 (mainly pneumopathy, lipase increase, endocrine disorders and asthenia) were related to N and occurred in 36 pts (10%). On the 89 AEs grade 5, 5 were considered related to N (3 pneumonitis, 1 hepatitis, 1 cardiac arrest). Median follow-up was 23.5 months (mo). 268 pts died. OS, PFS and ORR are reported in the table. Sex, ECOG, type of relapse and number of prior lines were significantly associated with OS in multivariate analysis. Sex and type of relapse were significantly associated with PFS and ORR in multivariate analysis. Table: 917MO

Median OS (mo) [95%CI] Median PFS (mo) [95%CI] ORR n (%)
All pts 7.5 [6.5; 8.9] 1.8 [1.8; 1.9] 56 (16)
Male 7.1 [5.9; 8,3] 1.8 [1.8; 1.9] 41 (15)
Female 12.7 [7.3; 14,6] 2.2 [1.7; 4.0] 15 (23)
<70 yr 7.5 [6.0; 8.9] 1.8 [1.8; 1.9] 39 (14)
≥70 yr 7.9 [6.0; 13.5] 2.4 [1.8; 3.6] 17 (23)
ECOG 0 14.8 [8.9; 18,8] 2.9 [1.8; 4.0] 16 (19)
ECOG 1 7.3 [5.6; 9,3] 1.8 [1.8; 2.0] 34 (17)
ECOG 2 3.1 [1.6; 5.5] 1.7 [1.3; 1.8] 6 (12)
LR relapse 7.3 [5.4; 9.0] 1.8 [1.7; 2.0] 16 (13)
Metastatic relapse 14.6 [8.3; 19.4] 2.8 [1.9; 3.6] 26 (25)
Both 4.7 [4.0; 7.1] 1.8 [1.7; 1.9] 14 (12)
No prior systemic treatment 4.5 [1.6; 12.7] 1.8 [1.1; 2.9] 5 (19)
1 prior line 9.3 [7.1; 11.5] 1.8 [1.8; 2.2] 32 (18)
≥2 prior lines 6.6 [4.9; 8.4] 1.9 [1.8; 2.0] 19 (13)

Conclusions

The final analysis of the TOPNIVO study shows no additional toxicities of N compared to what has been described previously, confirms the previous results in terms of efficacy with new data for prognostic factors.

Clinical trial identification

NCT03226756.

Editorial acknowledgement

Legal entity responsible for the study

Unicancer.

Funding

BMS.

Disclosure

C. Even: Advisory/Consultancy: BMS; Advisory/Consultancy: Innate Pharma; Advisory/Consultancy: MSD; Advisory/Consultancy: Merck Serono. A. Daste: Advisory/Consultancy, Travel/Accommodation/Expenses: BMS; Advisory/Consultancy, Travel/Accommodation/Expenses: AstraZeneca; Advisory/Consultancy, Travel/Accommodation/Expenses: Merck Serono; Advisory/Consultancy: MSD. J. Fayette: Advisory/Consultancy: MSD; Advisory/Consultancy: BMS; Advisory/Consultancy: AstraZeneca; Advisory/Consultancy: Roche; Advisory/Consultancy: Servier; Advisory/Consultancy: Merck Serono. E. Saada-Bouzid: Advisory/Consultancy, Travel/Accommodation/Expenses: BMS; Advisory/Consultancy, Travel/Accommodation/Expenses: MSD; Advisory/Consultancy, Travel/Accommodation/Expenses: AstraZeneca. C. Toullec: Honoraria (self), Travel/Accommodation/Expenses: Merck Serono; Honoraria (self), Travel/Accommodation/Expenses: Sanofi; Honoraria (self), Travel/Accommodation/Expenses: MSD; Honoraria (self), Travel/Accommodation/Expenses: Ipsen; Honoraria (self), Travel/Accommodation/Expenses: Amgen; Honoraria (self), Travel/Accommodation/Expenses: Servier; Honoraria (self), Travel/Accommodation/Expenses: BMS. A.C. Johnson: Travel/Accommodation/Expenses: BMS. C. Le Tourneau: Advisory/Consultancy: MSD; Advisory/Consultancy: BMS; Advisory/Consultancy: Merck Serono; Advisory/Consultancy: Roche; Advisory/Consultancy: AstraZeneca; Advisory/Consultancy: Seattle Genetics; Advisory/Consultancy: Rakuten; Advisory/Consultancy: Nanobiotix; Advisory/Consultancy: GSK. J. Guigay: Advisory/Consultancy, Research grant/Funding (institution): Merck Serono; Advisory/Consultancy, Research grant/Funding (institution): BMS; Advisory/Consultancy: Innate Pharma; Advisory/Consultancy: AstraZeneca. All other authors have declared no conflicts of interest.

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