Designation based on positive results of the Phase 3 study,
CheckMate -025, reinforcing significant unmet medical need in this
patient population
CheckMate -025 marks the first time any agent has demonstrated, as
a primary endpoint, an overall survival benefit vs. standard of care in
second-line metastatic renal cell carcinoma
PRINCETON, N.J.--(BUSINESS WIRE)--
Bristol-Myers
Squibb Company (NYSE:BMY) today announced that the U.S. Food
and Drug Administration (FDA) has granted Breakthrough Therapy
Designation to Opdivo for the potential indication of advanced or
metastatic renal cell carcinoma (RCC). The Breakthrough Therapy
designation is an FDA program intended to expedite the development and
review of medicines with early signals of potential clinical benefit in
serious diseases to help ensure patients have access to new therapies as
soon as possible.
This designation is based on results of CheckMate -025, a Phase 3 study
that evaluated the survival of patients with previously treated advanced
or metastatic clear-cell RCC versus everolimus, a current standard of
care for patients with previously treated kidney cancer. The trial was
stopped early in July 2015 because an assessment conducted by the
independent Data Monitoring Committee (DMC) concluded that the study met
its primary endpoint of overall survival, demonstrating superior overall
survival in patients receiving Opdivo compared to the control
arm. Bristol-Myers Squibb will be presenting further data from this
study at the upcoming 2015 European Cancer Congress (ECC), and looks
forward to submitting these data to regulatory authorities this year.
Michael Giordano, senior vice president, head of Development, Oncology
commented, “Results from CheckMate -025 mark the third tumor in which Opdivo
has shown an overall survival benefit in a Phase 3 trial. The
Breakthrough Therapy Designation in advanced renal cell carcinoma is a
clear signal of the need for additional treatment approaches for RCC and
reflects part of our broad commitment to Immuno-Oncology research that
may address many types of advanced cancers."
According to the FDA, the criteria for Breakthrough Therapy Designation
requires preliminary clinical evidence that demonstrates the medicine
may have substantial improvement on at least one clinically significant
endpoint over available therapy. This is the fourth Breakthrough Therapy
Designation granted for Opdivo by the FDA, with previous
indications including patients with Hodgkin lymphoma after failure of
autologous stem cell transplant and brentuximab, previously treated
advanced melanoma, and previously treated non-squamous non-small cell
lung cancer.
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
percent to 90 percent of all cases. RCC is approximately twice as common
in men as it is in women, with the highest rates of the disease found in
North America and Europe. Globally, the five-year survival rate for
those diagnosed with metastatic, or advanced kidney cancer, is 12.1
percent.
About Opdivo
Bristol-Myers Squibb has a broad, global development program to study Opdivo
in multiple tumor types consisting of more than 50 trials – as
monotherapy or in combination with other therapies – in which more than
8,000 patients have been enrolled worldwide.
Opdivo is a programmed death-1 (PD-1) immune checkpoint inhibitor
that has received approval from the U.S. Food and Drug Administration
(FDA) as a monotherapy in two cancer indications. Opdivo became
the first PD-1 immune checkpoint inhibitor to receive regulatory
approval anywhere in the world on July 4, 2014 when Ono Pharmaceutical
Co. announced that it received manufacturing and marketing approval in
Japan for the treatment of patients with unresectable melanoma. In the
U.S., the FDA granted its first approval for Opdivo for the
treatment of patients with unresectable or metastatic melanoma and
disease progression following Yervoy (ipilimumab) and, if BRAF
V600 mutation positive, a BRAF inhibitor. This indication is approved
under accelerated approval based on tumor response rate and durability
of response. Continued approval for this indication may be contingent
upon verification and description of clinical benefit in the
confirmatory trials. On March 4, 2015, Opdivo received its second
FDA approval for the treatment of patients with metastatic squamous
non-small cell lung cancer (NSCLC) with progression on or after
platinum-based chemotherapy. On July 20, the European Commission
approved Nivolumab BMS for the treatment of locally advanced or
metastatic squamous non-small cell lung cancer after prior chemotherapy.
IMPORTANT SAFETY INFORMATION
Immune-Mediated Pneumonitis
-
Severe pneumonitis or interstitial lung disease, including fatal
cases, occurred with OPDIVO treatment. Across the clinical trial
experience in 691 patients with solid tumors, fatal immune-mediated
pneumonitis occurred in 0.7% (5/691) of patients receiving OPDIVO; no
cases occurred in Trial 1 or Trial 3. In Trial 1, pneumonitis,
including interstitial lung disease, occurred in 3.4% (9/268) of
patients receiving OPDIVO and none of the 102 patients receiving
chemotherapy. Immune-mediated pneumonitis occurred in 2.2% (6/268) of
patients receiving OPDIVO; one with Grade 3 and five with Grade 2. In
Trial 3, immune-mediated pneumonitis occurred in 6% (7/117) of
patients receiving OPDIVO, including, five Grade 3 and two Grade 2
cases. Monitor patients for signs and symptoms of pneumonitis.
Administer corticosteroids for Grade 2 or greater pneumonitis.
Permanently discontinue OPDIVO for Grade 3 or 4 and withhold OPDIVO
until resolution for Grade 2.
Immune-Mediated Colitis
-
In Trial 1, diarrhea or colitis occurred in 21% (57/268) of patients
receiving OPDIVO and 18% (18/102) of patients receiving chemotherapy.
Immune-mediated colitis occurred in 2.2% (6/268) of patients receiving
OPDIVO; five with Grade 3 and one with Grade 2. In Trial 3, diarrhea
occurred in 21% (24/117) of patients receiving OPDIVO. Grade 3
immune-mediated colitis occurred in 0.9% (1/117) of patients. Monitor
patients for immune-mediated colitis. Administer corticosteroids for
Grade 2 (of more than 5 days duration), 3, or 4 colitis. Withhold
OPDIVO for Grade 2 or 3. Permanently discontinue OPDIVO for Grade 4
colitis or recurrent colitis upon restarting OPDIVO.
Immune-Mediated Hepatitis
-
In Trial 1, there was an increased incidence of liver test
abnormalities in the OPDIVO-treated group as compared to the
chemotherapy-treated group, with increases in AST (28% vs 12%),
alkaline phosphatase (22% vs 13%), ALT (16% vs 5%), and total
bilirubin (9% vs 0). Immune-mediated hepatitis occurred in 1.1%
(3/268) of patients receiving OPDIVO; two with Grade 3 and one with
Grade 2. In Trial 3, the incidences of increased liver test values
were AST (16%), alkaline phosphatase (14%), ALT (12%), and total
bilirubin (2.7%). Monitor patients for abnormal liver tests prior to
and periodically during treatment. Administer corticosteroids for
Grade 2 or greater transaminase elevations. Withhold OPDIVO for Grade
2 and permanently discontinue OPDIVO for Grade 3 or 4 immune-mediated
hepatitis.
Immune-Mediated Nephritis and Renal Dysfunction
-
In Trial 1, there was an increased incidence of elevated creatinine in
the OPDIVO-treated group as compared to the chemotherapy-treated group
(13% vs 9%). Grade 2 or 3 immune-mediated nephritis or renal
dysfunction occurred in 0.7% (2/268) of patients. In Trial 3, the
incidence of elevated creatinine was 22%. Immune-mediated renal
dysfunction (Grade 2) occurred in 0.9% (1/117) of patients. Monitor
patients for elevated serum creatinine prior to and periodically
during treatment. For Grade 2 or 3 serum creatinine elevation,
withhold OPDIVO and administer corticosteroids; if worsening or no
improvement occurs, permanently discontinue OPDIVO. Administer
corticosteroids for Grade 4 serum creatinine elevation and permanently
discontinue OPDIVO.
Immune-Mediated Hypothyroidism and Hyperthyroidism 1506US14BR02626-03-01
03/15
-
In Trial 1, Grade 1 or 2 hypothyroidism occurred in 8% (21/268) of
patients receiving OPDIVO and none of the 102 patients receiving
chemotherapy. Grade 1 or 2 hyperthyroidism occurred in 3% (8/268) of
patients receiving OPDIVO and 1% (1/102) of patients receiving
chemotherapy. In Trial 3, hypothyroidism occurred in 4.3% (5/117) of
patients receiving OPDIVO. Hyperthyroidism occurred in 1.7% (2/117) of
patients, including one Grade 2 case. Monitor thyroid function prior
to and periodically during treatment. Administer hormone replacement
therapy for hypothyroidism. Initiate medical management for control of
hyperthyroidism.
Other Immune-Mediated Adverse Reactions
-
In Trial 1 and 3 (n=385), the following clinically significant
immune-mediated adverse reactions occurred in <2% of OPDIVO-treated
patients: adrenal insufficiency, uveitis, pancreatitis, facial and
abducens nerve paresis, demyeliniation, autoimmune neuropathy, motor
dysfunction, and vasculitis. Across clinical trials of OPDIVO
administered at doses 3 mg/kg and 10 mg/kg, additional clinically
significant, immune-mediated adverse reactions were identified:
hypophysitis, diabetic ketoacidosis, hypopituitarism, Guillain-Barré
syndrome, and myasthenic syndrome. Based on the severity of adverse
reaction, withhold OPDIVO, administer high-dose corticosteroids, and,
if appropriate, initiate hormone- replacement therapy.
Embryofetal Toxicity
-
Based on its mechanism of action, OPDIVO can cause fetal harm when
administered to a pregnant woman. Advise pregnant women of the
potential risk to a fetus. Advise females of reproductive potential to
use effective contraception during treatment with OPDIVO and for at
least 5 months after the last dose of OPDIVO.
Lactation
-
It is not known whether OPDIVO is present in human milk. Because many
drugs, including antibodies, are excreted in human milk and because of
the potential for serious adverse reactions in nursing infants from
OPDIVO, advise women to discontinue breastfeeding during treatment.
Serious Adverse Reactions
-
In Trial 1, serious adverse reactions occurred in 41% of patients
receiving OPDIVO. Grade 3 and 4 adverse reactions occurred in 42% of
patients receiving OPDIVO. The most frequent Grade 3 and 4 adverse
drug reactions reported in 2% to <5% of patients receiving OPDIVO were
abdominal pain, hyponatremia, increased aspartate aminotransferase,
and increased lipase.
-
In Trial 3, serious adverse reactions occurred in 59% of patients
receiving OPDIVO. The most frequent serious adverse drug reactions
reported in =2% of patients were dyspnea, pneumonia, chronic
obstructive pulmonary disease exacerbation, pneumonitis,
hypercalcemia, pleural effusion, hemoptysis, and pain.
Common Adverse Reactions
-
The most common adverse reactions (=20%) reported with OPDIVO in Trial
1 were rash (21%) and in Trial 3 were fatigue (50%), dyspnea (38%),
musculoskeletal pain (36%), decreased appetite (35%), cough (32%),
nausea (29%), and constipation (24%).
Please see U.S. Full
Prescribing Information for OPDIVO.
Immuno-Oncology at Bristol-Myers Squibb
Surgery, radiation, cytotoxic or targeted therapies have represented the
mainstay of cancer treatment over the last several decades, but
long-term survival and a positive quality of life have remained elusive
for many patients with advanced disease.
To address this unmet medical need, Bristol-Myers Squibb is leading
research in an innovative field of cancer research and treatment known
as Immuno-Oncology, which involves agents whose primary mechanism is to
work directly with the body’s immune system to fight cancer. The company
is exploring a variety of compounds and immunotherapeutic approaches for
patients with different types of cancer, including researching the
potential of combining Immuno-Oncology agents that target different
pathways in the treatment of cancer.
Bristol-Myers Squibb is committed to advancing the science of
Immuno-Oncology, with the goal of changing survival expectations and the
way patients live with cancer.
About the Bristol-Myers Squibb and Ono
Pharmaceutical Collaboration
In 2011, through a collaboration agreement with Ono Pharmaceutical Co.,
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 www.bms.com,
or follow us on Twitter at http://twitter.com/bmsnews.
Bristol-Myers Squibb Forward-Looking Statement
This press release contains "forward-looking statements" as that term
is defined in the Private Securities Litigation Reform Act of 1995
regarding the research, development and commercialization of
pharmaceutical products. Such forward-looking statements are based on
current expectations and involve inherent risks and uncertainties,
including factors that could delay, divert or change any of them, and
could cause actual outcomes and results to differ materially from
current expectations. No forward-looking statement can be guaranteed.
Among other risks, there can be no guarantee that Opdivo will receive
regulatory approval for the additional indication described in this
release. Forward-looking statements in this press release should be
evaluated together with the many uncertainties that affect Bristol-Myers
Squibb's business, particularly those identified in the cautionary
factors discussion in Bristol-Myers Squibb's Annual Report on Form 10-K
for the year ended December 31, 2014 in our Quarterly Reports on Form
10-Q and our Current Reports on Form 8-K. Bristol-Myers Squibb
undertakes no obligation to publicly update any forward-looking
statement, whether as a result of new information, future events or
otherwise.

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Source: Bristol-Myers Squibb