NSCLC: CheckMate 017 trial

Abbreviations

No EU-CTR

Investigated (inv)
Comparator (comp)

NIVO

doce

135

137

Phase:

3

Randomisation:

Open label

Primary tumour:

NSCLC

Subtype (biomarker):

Squamous

Stage:

meta

Line of therapy:

L2

Primary
NIVO
doce
HR
p
OS
9.2 mo
6.0 mo
0.59 (0.44-0.79)
<0.001
PFS
3.5 mo
2.8 mo
0.62 (0.47-0.81)
<0.001
Secondaries
NIVO
doce
HR
p
ORR
20%
9%
0.008
OS @1yr
42%
24%
Time to reponse
2.2 mo
2.1 mo
DoR
NR
8.4 mo
(all grades, %)
NIVO
doce
p
Treatment-related AE gr. 3-4
7%
55%
NA
Fatigue
16
33
NA
Nausea
9
23
NA
Diarrhea
8
20
NA
Pneumonitis
5
0
NA
Rash
4
6
NA
Anemia
2
22
NA
Peripheral neuropathy
1
12
NA
Leukopenia
1
6
NA
Neutropenia
1
33
NA
Febrile neutropenia
0
11
NA
Alopecia
0
22
NA
Mucosal inflammation
2
9
NA
Myalgia
2
10
NA
  • Inclusion
  • Exclusion

- Men and women ≥18 years of age - Subjects with histologically or cytologically-documented squamous cell NSCLC who present with Stage IIIB/IV disease or with recurrent or progressive disease following multimodal therapy (radiation therapy, surgical resection or definitive chemoradiation therapy for locally advanced disease) - Disease recurrence or progression during/after one prior platinum doublet-based chemotherapy regimen for advanced or metastatic disease - Measurable disease by computed tomography (CT)/Magnetic resonance imaging (MRI) per Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria - Eastern Cooperative Oncology Group (ECOG) performance status ≤1 - A formalin fixed, paraffin-embedded (FFPE) tumor tissue block or unstained slides of tumor sample (archival or recent) must be available for biomarker evaluation. Specimens must be received by the central lab prior to randomization. Biopsy should be excisional, incisional or core needle.

- Subjects with untreated central nervous system (CNS) metastases are excluded. Subjects are eligible if CNS metastases are treated and subjects are neurologically returned to baseline for at least 2 weeks prior to enrollment. In addition, subjects must be either off corticosteroids, or on a stable or decreasing dose of ≤10 mg daily prednisone (or equivalent) - Subjects with carcinomatous meningitis - Subjects with active, known or suspected autoimmune disease. Subjects with type I diabetes mellitus, hypothyroidism only requiring hormone replacement, skin disorders (such as vitiligo, psoriasis, or alopecia) not requiring systemic treatment, or conditions not expected to recur in the absence of an external trigger are permitted to enroll - Subjects with a condition requiring systemic treatment with either corticosteroids or other immunosuppressive medications within 14 days of randomization - Prior therapy with anti-Programmed death-1 (PD-1), anti-Programmed cell death ligand 1 (PD-L1), anti-Programmed cell death ligand 2 (PD-L2), anti-CD137, or anti-Cytotoxic T lymphocyte-associated antigen 4 (CTLA-4) antibody (including ipilimumab or any other antibody or drug specifically targeting T-cell co-stimulation or checkpoint pathways) - Prior treatment on the first line study CA184104 first line NSCLC study - Prior treatment with Docetaxel - Subjects with interstitial lung disease that is symptomatic or may interfere with the detection or management of suspected drug-related pulmonary toxicity - Treatment with any investigational agent within 14 days of the first administration of study treatment.

Characteristics
NIVO
doce
Age
Median age (range) yr
62 (39-85)
64 (42-84)
<65 yr
79 (59)
73 (53)
≥65 to <75 yr
45 (33)
46 (34)
≥75 yr
11 (8)
18 (13)
Sex - no.(%)
Male
111 (82)
97 (71)
Female
24 (18)
40 (29)
Race - no.(%)
White
122 (90)
130 (95)
Black
6 (4)
2 (1)
Asian
4 (3)
2 (1)
Other
1 (1)
2 (1)
Disease stage - no.(%)
IIIB
29 (21)
24 (18)
IV
105 (78)
112 (82)
Not reported
1 (1)
1 (1)
ECOG PS score - no.(%)
0
27 (20)
37 (27)
1
106 (79)
100 (73)
Not reported
2 (1)
0
CNS metastasis - no.(%)
Yes
9 (7)
8 (6)
No
126 (93)
129 (94)
Smoking status - no.(%)
Current or former smoker
121 (90)
129 (94)
Never smoked
10 (7)
7 (5)
Unknown
4 (3)
1 (1)
Geographic region - no.(%)
United States or Canada
43 (32)
43 (31)
Europe
77 (57)
78 (57)
Rest of world
15 (11)
16 (12)
Other systemic cancer therapy - no.(%)
Bevacizumab
1 (1)
1 (1)
Cetuximab
0
2 (1)
Etoposide
17 (13)
11 (8)
Fluorouracil
1 (1)
0
Other systemic cancer therapy - no.(%)
Gemcitabine
60 (44)
71 (52)
Paclitaxel
46 (34)
46 (34)
Pemetrexed
3 (2)
3 (2)
Vinorelbine
20 (15)
24 (18)
Best response to most recent prior systemic regimen - no.(%)
CR or PR
48 (36)
43 (31)
SD
33 (24)
47 (34)
PD
44 (33)
41 (30)
Unknown or not reported
10 (7)
6 (4)
Time from completion of most recent prior systemic regimen
<3 mo
64 (47)
59 (43)
3-6 mo
35 (26)
40 (29)
>6 mo
35 (26)
37 (27)
Unknown
1 (1)
1 (1)
Ad-hoc:
no.pts inv.
no.pts comp.
NIVO
doce
HR
p
OS (PD-L1≥1%)
63
56
-
-
0.69 (0.45–1.05)
OS (PD-L1<1%)
54
52
-
-
0.58 (0.37–0.92)
OS (PD-L1≥5%)
42
39
-
-
0.53 (0.31–0.89)
  • OS
  • PFS
analisys of OS
NIVO
doce
HR (95% CI)
Age
<65 yr (n=152)
0.52 (0.35-0.75)
≥65 to <75 yr (n=91)
0.56 (0.34-0.91)
Prior paclitaxel vs other prior treatment
Prior paclitaxel (n=92)
0.51 (0.31-0.83)
Another agent (n=180)
0.63 (0.45-0.90)
Prior patient regimen
Cisplatin (n=90)
0.67 (0.41-1.10)
Carboplatin (n=182)
0.55 (0.39-0.78)
ECOG
0 (n=64)
0.48 (0.24-0.99)
1 (n=206)
0.54 (0.39-0.74)
Time from diagnosis to randomisation
<1 yr (n=193)
0.55 (0.39-0.77)
Other (n=79)
0.73 (0.42-1.26)
Sex
Male (n=208)
0.57 (0.41-0.78)
Female (n=64)
0.67 (0.36-1.25)
Other
No CNS metastasis (n=255)
0.60 (0.45-0.60)
Current/former smoker (n=250)
0.59 (0.44-0.80)
analisys of PFS
NIVO
doce
HR (95% CI)
PD-L1 status (n)
≥1% (119)
0.67 (0.44–1.01)
<1% (106)
0.66 (0.43–1.00)
PD-L1 status (n)
≥5% (81)
0.54 (0.32–0.90)
<5% (144)
0.75 (0.52–1.08)
PD-L1 status (n)
≥10% (69)
0.58 (0.33–1.02)
<10% (156)
0.70 (0.49–0.99)