Opdivo is the only PD-1 immune checkpoint inhibitor to show a
sustained survival benefit in this patient population, as demonstrated
in both CheckMate -017 and -063
Clinical benefit observed among both PD-L1 expressors and
non-expressors, across both trials
Safety and tolerability profile at 18 month follow-up is
consistent with previously-reported results from these trials
PRINCETON, N.J.--(BUSINESS WIRE)--
Bristol-Myers
Squibb Company (NYSE:BMY) today announced longer term
survival and safety data from CheckMate -017 and -063, two pivotal
trials evaluating Opdivo in previously treated squamous (SQ)
non-small cell lung cancer (NSCLC), showing sustained survival benefit
across these studies. In both trials, Opdivo showed an estimated
18 month overall survival (OS) rate of 27% (CheckMate -063) to 28%
(CheckMate -017); survival benefit was independent of PD-L1 expression.
The safety profile of Opdivo is consistent with
previously-reported trials, and in CheckMate -017, is also favorable
compared to docetaxel. These data will be presented today at the 16th
World Conference on Lung Cancer (Abstract #736, CheckMate -017 and #828,
CheckMate -063).
“Immuno-Oncology agents like Opdivo provide a novel approach to
treating cancer. The improvement in survival observed in advanced
squamous non-small cell lung cancer represents an important step forward
for our patients,” said Suresh S. Ramalingam, M.D., director, Division
of Medical Oncology, Winship Cancer Institute of Emory University.
“These updated results demonstrate the ability to achieve longer term
survival outcomes in this patient population. In fact, the Kaplan-Meier
curve from this study suggests a prolonged survival benefit for a subset
of patients.”
Previously-reported one year results from CheckMate -017 showed a
significantly superior OS rate of 42% versus 24% for docetaxel. In
CheckMate -063, the estimated one-year survival rate was 39%. (see table
below)
|
|
|
CheckMate -017
|
|
CheckMate -063
|
|
|
Nivolumab N = 135
|
|
Docetaxel N = 137
|
|
Nivolumab N = 117
|
|
1-Year Overall Survival
|
|
42%
|
|
24%
|
|
39%
|
|
18-Month Overall Survival
|
|
28%
|
|
13%
|
|
27%
|
|
|
|
|
|
|
|
|
“Our approach to Immuno-Oncology research is intended to show meaningful
improvement over the traditional standard of care on the benchmark
endpoint of overall survival,” said Michael Giordano, senior vice
president, head of Development, Oncology. “We have taken a comprehensive
research approach in lung cancer, one focused on a commitment to
providing the first major advancement in squamous non-small cell lung
cancer in more than a decade – Opdivo – that offers the potential
to replace chemotherapy. With the data presented today, we remain
confident in our Immuno-Oncology strategy, including fulfilling our goal
in showing the survival benefit for Opdivo, not only in non-small
cell lung cancer, but similar to the data already observed in advanced
melanoma and other tumor types.”
About CheckMate -017 & CheckMate -063
CheckMate -017 and CheckMate -063 demonstrated the efficacy and safety
of Opdivo in patients with advanced or metastatic SQ NSCLC who
had progressed following previous chemotherapy treatment. Together, the
trials investigated Opdivo monotherapy at a dose of 3 mg/kg every
two weeks, which has been well-established across the Phase 3 Opdivo clinical
development programs for various tumors. These trials also formed the
basis for Opdivo’s approvals in the U.S. and European Union, and
helped to establish the agent as standard of care for previously treated
SQ NSCLC.
CheckMate -017 is a landmark Phase 3, open-label, randomized clinical
trial that evaluated Opdivo (n=135) 3mg/kg intravenously over 60
minutes every two weeks versus standard of care, docetaxel (n=137) 75
mg/m2 intravenously administered every three weeks in
patients with advanced SQ NSCLC who had progressed during or after one
prior platinum doublet-based chemotherapy regimen. The study’s primary
endpoint was OS and secondary endpoints included progression-free
survival (PFS) and objective response rate (ORR). The trial included
patients regardless of their PD-L1 expression status.
CheckMate -017 showed a doubling in 18 month OS benefit with an
estimated 28% of patients alive at 18 months for Opdivo versus
13% for docetaxel. The median OS for the Opdivo arm was 9.2
months and 6.0 months for docetaxel (hazard ratio: 0.62 [95% CI, 0.48,
0.81; P = 0.0004]). In addition, Opdivo showed a statistically
significant improvement in PFS and ORR. The PFS rate at 18 months was
17% for the Opdivo arm versus 2.7% for docetaxel. Median PFS was
3.5 months for patients administered Opdivo versus 2.8 months for
docetaxel (hazard ratio: 0.63; [95% CI, 0.48, 0.83; P = 0.0008]). The
ORR was 20% for the Opdivo arm versus 9% for docetaxel for an
estimated odds ratio of 2.6 (95% CI, 1.3, 5.5; P = 0.0083), with an
ongoing response seen in 63% of patients treated with Opdivo. In
the trial, 28 patients were treated with Opdivo beyond initial
progression, and nine demonstrated a non-conventional pattern of benefit
(7%). The safety profile of Opdivo continued to be favorable
versus docetaxel and treatment-related AEs occurred less frequently with Opdivo (n=131;
any grade, 59%; grade 3–5, 8%; no grade 5 events) than docetaxel (n=129;
any grade, 87%; grade 3–5, 58%), including both hematologic and
non-hematologic toxicities. The majority of treatment-related select AEs
in patients receiving Opdivo occurred within the first three
months of treatment.
CheckMate -063 is a Phase 2, single-arm, open-label trial that included
patients with metastatic SQ NSCLC who had progressed after receiving a
platinum-based therapy and at least one additional systemic treatment
regimen (n=117). In this trial, Opdivo showed an estimated
18-month OS rate of 27%. At 18 months, confirmed objective response
rate, the study’s primary endpoint, was 15% (95% CI: 9, 22). Median OS
was 8.1 months (95% CI: 6.1, 10.9). Most treatment-related AEs were of
low grade (any grade, 75%; grade 3-4, 17%) and managed using established
treatment algorithms.
About Lung Cancer
Lung cancer is the leading cause of cancer deaths globally, resulting in
more than 1.5 million deaths each year, according to the World Health
Organization. Lung cancer results in more deaths worldwide than
colorectal, breast and prostate cancers combined. Non-small cell lung
cancer (NSCLC) is one of the most common types of the disease and
accounts for approximately 85% of cases. Squamous cell NSCLC accounts
for approximately 25% to 30% of all lung cancer cases. Five year
survival rates vary globally depending on the stage and type of lung
cancer.
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 a
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 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 Food and Drug
Administration (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. On March 4, 2015, Opdivo received
its second FDA approval for the treatment of patients with metastatic
squamous (SQ) 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 SQ NSCLC after prior chemotherapy.
INDICATION
OPDIVO® (nivolumab) is indicated for the treatment of
patients with metastatic squamous non-small cell lung cancer (NSCLC)
with progression on or after platinum-based 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
-
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 at www.bms.com.
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 Pharmaceutical
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.
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.

View source version on businesswire.com: http://www.businesswire.com/news/home/20150907005058/en/
Source: Bristol-Myers Squibb Company