New Data on Bristol-Myers Squibb’s Opdivo Indicate Benefit
OREANDA-NEWS. Bristol-Myers Squibb Company announced results from CheckMate -205, a multi-cohort, non-comparative, single-arm, Phase 2 registrational trial evaluating Opdivo (nivolumab) in patients with classical Hodgkin lymphoma (cHL). These results, from cohort B of the trial, included patients who had relapsed or progressed after autologous hematopoietic stem cell transplantation (auto-HSCT) and post-transplantation brentuximab vedotin (n=80). The primary endpoint of objective response rate (ORR) per an independent radiologic review committee (IRRC) was 66.3% (95% CI: 54.8-76.4). Median time to response was 2.1 months, and estimated median duration of remission was 7.8 months (95% CI: 6.6-NE). The majority of responses (62.3%) were ongoing at the time of analysis. In an exploratory analysis, the authors observed more than two-thirds (72.1%) of patients who did not respond to most recent prior brentuximab vedotin treatment did respond to Opdivo. The safety profile of Opdivo in CheckMate -205 was consistent with previously reported data in this tumor type.
These data will be presented at the 21st Congress of the European Hematology Association (EHA) in Copenhagen, Denmark on Sunday, June 12 from 8:00 – 8:15 a.m. CEST (Abstract #S793) and is in press with The Lancet Oncology.
“There is currently no standard treatment option for classical Hodgkin lymphoma patients who have relapsed or whose disease has progressed after auto-HSCT and post-transplantation brentuximab vedotin,” said Andreas Engert, M.D., lead investigator and professor of Internal Medicine, Hematology and Oncology, University Hospital of Cologne, Cologne, Germany. “We are encouraged by the objective response rates and that the majority of responses were ongoing at the time of analysis in the CheckMate -205 trial evaluating Opdivo in these heavily pre-treated patients.”
“Classical Hodgkin lymphoma is a disease that disproportionately impacts young people, and there is a significant unmet need for patients who are not cured by the current standard-of-care treatments and who have a poor prognosis and very limited options,” said Jean Viallet, M.D., Global Clinical Research Lead, Oncology, Bristol-Myers Squibb. “The data presented at EHA demonstrate that Opdivo is an important treatment option for patients whose disease has progressed after auto-HSCT and post-transplantation brentuximab vedotin.”
Opdivo recently received its first U.S. Food and Drug Administration approval in hematology on May 17, 2016, which also marks the first approval of a PD-1 inhibitor in a hematological malignancy. It was granted accelerated approval based on overall response rate for the treatment of patients with cHL who have relapsed or progressed after auto-HSCT and post-transplantation brentuximab vedotin based on a combined analysis of data from the Phase 2 CheckMate -205 trial, which were more limited than the data being presented at EHA, and the Phase 1 CheckMate -039 trial. Continued approval for this indication may be contingent upon verification and description of clinical benefit in confirmatory trials. Opdivo also is currently under regulatory review for cHL in the European Union and Japan.
About CheckMate -205
CheckMate -205 is a Phase 2, single-arm, open-label, international, multicenter, multi-cohort study that included the evaluation of Opdivo in adult patients with cHL. All patients in cohort B had failed both auto-HSCT and subsequent brentuximab vedotin. The median number of prior lines of therapy was four, and 49% had received at least five previous lines of therapy. Patients enrolled in this trial were treated with Opdivo 3 mg/kg intravenously every two weeks until disease progression or unacceptable toxicity.
The primary endpoint was ORR by IRRC assessment. Secondary endpoints based on IRRC assessment included duration of objective response, complete and partial remission rates, duration of complete and partial remission, and based on investigator assessment, objective response and duration of objective response. Exploratory endpoints included IRRC-assessed progression-free survival (PFS), overall survival (OS), safety and tolerability, and quality of life. Investigator-assessed ORR was 72.5% (95% CI: 61.4–81.9). Best overall response was complete and partial remission in 27.5% and 45.0%. At six months, the IRRC-assessed PFS rate was 76.9% (95% CI: 65-85), and the OS rate was 98.7% (95% CI: 91.0-99.8), whereas median PFS was 10 months (95% CI: 8.41–NA). The safety profile of Opdivo in CheckMate -205 remained consistent with previously reported data in this tumor type.
Classical Hodgkin lymphoma is characterized by Reed-Sternberg cells, which exhibit 9p24.1, resulting in overexpression of PD-1 ligands PD-L1 and PD-L2 on the tumor cell surface. Increased PD-L1 and PD-L2 expression by Reed-Sternberg cells may enable these cells to evade detection by the immune system. An exploratory analysis evaluated the association between the 9p24.1 genetic alteration, programmed death 1 (PD-1) ligand expression and IRRC-assessed ORR. Responses were reported in patients with any level of 9p24.1 alteration.
The most common drug-related adverse events were fatigue (25%; 20/80), infusion-related reaction (20%; 16/80), rash (16%; 13/80), arthralgia (14%; 11/80), pyrexia (14%; 11/80), nausea (13%; 10/80), diarrhea (10%; 8/80), and pruritus (10%; 8/80). Grade 3/4 adverse events occurred in 32 patients (40%), and one Grade 5 event occurred (1%; multi-organ failure). Serious adverse events of any cause were reported in 20 patients (25%; 20/80), the most common being pyrexia (4%; 3/8), and drug-related serious adverse events in five patients (6%), the most common being infusion-related reaction (3%). Extended safety follow-up of cHL patients treated in the nivolumab clinical trial program subsequently treated with allogeneic HSCT (N=17) identified complications, including fatal events.
Bristol-Myers Squibb & Immuno-Oncology: Advancing Oncology Research
At Bristol-Myers Squibb, we have a vision for the future of cancer care that is focused on Immuno-Oncology, now considered a major treatment choice alongside surgery, radiation, chemotherapy and targeted therapies for certain types of cancer.
We have a comprehensive clinical portfolio of investigational and approved Immuno-Oncology agents, many of which were discovered and developed by our scientists. Our ongoing Immuno-Oncology clinical program is looking at broad patient populations, across multiple solid tumors and hematologic malignancies, and lines of therapy and histologies, with the intent of powering our trials for overall survival and other important measures like durability of response. We pioneered the research leading to the first regulatory approval for the combination of two Immuno-Oncology agents and continue to study the role of combinations in cancer.
We are also investigating other immune system pathways in the treatment of cancer including CTLA-4, CD-137, KIR, SLAMF7, PD-1, GITR, CSF1R, IDO and LAG-3. These pathways may lead to potential new treatment options – in combination or monotherapy – to help patients fight different types of cancers.
Our collaboration with academia, as well as small and large biotech companies, to research the potential of Immuno-Oncology and non-Immuno-Oncology combinations helps achieve our goal of providing new treatment options in clinical practice.
At Bristol-Myers Squibb, we are committed to changing survival expectations in hard-to-treat cancers and the way patients live with cancer.
Cancer cells may exploit “regulatory” pathways, such as checkpoint pathways, to hide from the immune system and shield the tumor from immune attack. Opdivo is a PD-1 immune checkpoint inhibitor that binds to the checkpoint receptor PD-1 expressed on activated T-cells, and blocks the binding of PD-L1 and PD-L2, preventing the PD-1 pathway’s suppressive signaling on the immune system, including the interference with an anti-tumor immune response.
Opdivo’s broad global development program is based on Bristol-Myers Squibb’s understanding of the biology behind Immuno-Oncology. Our company is at the forefront of researching the potential of Immuno-Oncology to extend survival in hard-to-treat cancers. This scientific expertise serves as the basis for the Opdivo development program, which includes a broad range of Phase 3 clinical trials evaluating overall survival as the primary endpoint across a variety of tumor types. The Opdivo trials have also contributed toward the clinical and scientific understanding of the role of biomarkers and how patients may benefit from Opdivo across the continuum of PD-L1 expression. To date, the Opdivo clinical development program has enrolled more than 18,000 patients.
Opdivo was the first PD-1 immune checkpoint inhibitor to receive regulatory approval anywhere in the world in July 2014 and currently has regulatory approval in 51 countries including the United States, Japan and in the European Union.
U.S. INDICATIONS & IMPORTANT SAFETY INFORMATION
OPDIVO® (nivolumab) as a single agent is indicated for the treatment of patients with BRAF V600 wild-type unresectable or metastatic melanoma.
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 confirmatory trials.
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 patients with classical Hodgkin lymphoma (cHL) that has relapsed or progressed after autologous hematopoietic stem cell transplantation (HSCT) and post-transplantation brentuximab vedotin. 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.