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An Exploratory Study of the Effects of Nivolumab Combined With Ipilimumab in Patients With Treatment-Naive Stage IV or Recurrent Non-Small Cell Lung Cancer (NSCLC)

Phase 2
Completed
Conditions
Non-Small Cell Lung Cancer
Interventions
Biological: Nivolumab
Biological: Ipilimumab
Registration Number
NCT03001882
Lead Sponsor
Bristol-Myers Squibb
Brief Summary

The purpose of this study is to explore the possible links between participant characteristics and their cancer, with how effective the combination of nivolumab with ipilimumab is, in participants with Stage IV or recurrent Non-Small Cell Lung Cancer (NSCLC).

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
230
Inclusion Criteria
  • Histologically confirmed, stage IV or recurrent non-small cell lung cancer with no prior systemic anticancer therapy given as primary therapy for advanced or metastatic disease
  • Measurable disease by CT or MRI
  • Must have full activity or, if limited, must be able to walk and carry out light activities such as light house work or office work
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Exclusion Criteria
  • Participants with untreated central nervous system metastases
  • Participants with active, known or suspected autoimmune disease
  • Prior treatment with any drug that targets T cell co-stimulations pathways (such as checkpoint inhibitors)

Other protocol defined inclusion/exclusion criteria apply

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Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Combination therapyIpilimumabNivolumab + Ipilimumab
Combination therapyNivolumabNivolumab + Ipilimumab
Primary Outcome Measures
NameTimeMethod
Objective Response Rate (ORR) Per Investigator by Blood TMB (bTMB) Within PD-L1 Subgroup (TMB Cut-point = 16 Mutations/MB)From first dose up to the date of objectively documented progression, or the date of initiation of palliative local therapy or the date of initiation of subsequent anticancer therapy (up to approximately 58 months)

Objective response rate (ORR) is defined as the percent of treated participants with a best overall response of a complete response (CR) or partial response (PR) assessed by investigator per Response Evaluation Criteria In Solid Tumors (RECIST 1.1).

PR is at least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters. CR is disappearance of all target lesions and a reduction in pathological lymph node (whether target or non-target) short axis to \<10 mm.

Blood tumor mutational burden (bTMB) is the total number of nonsynonymous somatic mutations produced by a tumor that are detected in serum.

CR+PR, confidence interval based on the Clopper and Pearson method.

Objective Response Rate (ORR) Per Investigator by Tissue TMB Within PD-L1 Subgroup (Tissue TMB Cut-point = 10-mutations/MB)From first dose up to the date of objectively documented progression, or the date of initiation of palliative local therapy or the date of initiation of subsequent anticancer therapy (up to approximately 58 months)

Objective response rate (ORR) is defined as the percent of treated participants with a best overall response of a complete response (CR) or partial response (PR) assessed by investigator per Response Evaluation Criteria In Solid Tumors (RECIST 1.1).

PR is at least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters. CR is disappearance of all target lesions and a reduction in pathological lymph node (whether target or non-target) short axis to \<10 mm.

Tissue tumor mutational burden (tTMB) is the total number of nonsynonymous somatic mutations produced by a tumor that are detected in tumor tissue samples.

CR+PR, confidence interval based on the Clopper and Pearson method.

Objective Response Rate (ORR) Per Investigator by Blood TMB (bTMB) Within PD-L1 Subgroup (Blood TMB Cut-point = 21-mutations/MB)From first dose up to the date of objectively documented progression, or the date of initiation of palliative local therapy or the date of initiation of subsequent anticancer therapy (up to approximately 58 months)

Objective response rate (ORR) is defined as the percent of treated participants with a best overall response of a complete response (CR) or partial response (PR) assessed by investigator per Response Evaluation Criteria In Solid Tumors (RECIST 1.1).

PR is at least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters. CR is disappearance of all target lesions and a reduction in pathological lymph node (whether target or non-target) short axis to \<10 mm.

Blood tumor mutational burden (bTMB) is the total number of nonsynonymous somatic mutations produced by a tumor that are detected in serum.

CR+PR, confidence interval based on the Clopper and Pearson method.

Secondary Outcome Measures
NameTimeMethod
Objective Response Rate (ORR) for All Treated Participants by Investigator Per RECIST 1.1From first dose until the date of objectively documented progression, or the date of initiation of palliative local therapy or the date of initiation of subsequent anticancer therapy, whichever occurs first (Up to approximately 67 months)

Objective response rate (ORR) is defined as the percent of treated participants with a best overall response of a complete response (CR) or partial response (PR) assessed by investigator per Response Evaluation Criteria In Solid Tumors (RECIST 1.1).

Partial Response (PR) is at least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters. Complete Response (CR) is disappearance of all target lesions and a reduction in pathological lymph node (whether target or non-target) short axis to \<10 mm.

CR+PR, confidence interval based on the Clopper and Pearson method.

Duration of Response (DOR) for Part 1From first dose to the date of the first documented tumor progression or death due to any cause (Up to approximately 67 months)

DOR is the time between first confirmed response (Complete/Partial Response) and first documented tumor progression (per RECIST 1.1) or death due to any cause. Participants who don't progress or die are censored on the date of their last evaluable tumor assessment. Participants who started subsequent anti-cancer therapy without prior reported progression were censored at the last evaluable tumor assessment prior to or on the date of subsequent anti-cancer therapy.

PR is at least 30% decrease in the sum of diameters of target lesions, using baseline sum diameters as reference. CR is disappearance of all target lesions and reduction in short axis to \<10 mm of any pathological lymph nodes (target or non-target). Progressive Disease (PD) is at least 20% increase in the sum of diameters of target lesions, taking the smallest sum as reference. The sum must also show an overall increase of \> 5 mm. (one or more new lesions is also progression). Median computed using Kaplan-Meier method.

Time to Response (TTR) for Part 1From first dose to the time the criteria for Complete Response/Partial Response are first met (Up to approximately 67 months)

TTR is the time taken from first dosing date to the time the criteria for Complete Response (CR)/Partial Response (PR) are first met.

Partial Response (PR) is at least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters. Complete Response (CR) is disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \<10 mm.

Disease Control Rate (DCR) for Part 1From first dose until the date of objectively documented progression, or the date of initiation of palliative local therapy or the date of initiation of subsequent anticancer therapy, whichever occurs first (Up to approximately 67 months)

Disease control rate (DCR) is the percent of treated participants with a best overall response of a complete response (CR), partial response (PR), or stable disease (SD), assessed by investigator per Response Evaluation Criteria In Solid Tumors (RECIST 1.1).

PR is at least a 30% decrease in the sum of diameters of target lesions, using the baseline sum diameters as reference. CR is disappearance of all target lesions and a reduction in short axis to \<10 mm of any pathological lymph nodes (target or non-target). SD is neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for progressive disease (PD), taking smallest sum diameters as reference. PD is at least a 20% increase in the sum of diameters of target lesions, taking the smallest sum as reference. The sum must also demonstrate an absolute increase of at least 5 mm. (one or more new lesions is also considered progression). CR+PR, confidence interval based on the Clopper and Pearson method.

Progression Free Survival (PFS)From first dose to the date of the first documented tumor progression or death due to any causes (Assessed up to approximately 67 months)

PFS is defined as the time from first dosing date to the date of the first documented tumor progression (per RECIST 1.1) or death due to any cause.

Participants who neither progress nor die will be censored on the date of their last evaluable tumor assessment. Participants who started any subsequent anti-cancer therapy without a prior reported progression will be censored at the last evaluable tumor assessment prior to or on the date of initiation of subsequent anti-cancer therapy.

Progressive Disease (PD) is at least a 20% increase in the sum of diameters of target lesions, taking the smallest sum on study as reference. The sum must also show an overall increase of \> 5 mm. (one or more new lesions is also progression).

Median calculated using Kaplan-Meier estimates.

Number of Participants With Select Adverse Events (AEs) for Study Part 2From first dose to 30 days after last dosing date (up to approximately 27 months)

An Adverse Event (AE) is any new untoward medical occurrence or worsening preexisting medical condition in a treated participant and that does not necessarily have a causal relationship with treatment.

An AE can be any unfavorable, unintended sign, symptom, or disease temporally associated with the use of treatment, whether or not related to the treatment.

Overall Survival (OS)From first dose to the date of death (Assessed up to approximately 67 months)

OS is defined as the time from first dosing date to the date of death. If a participant didn't die, OS will be censored on the last date the participant was known to be alive.

Median based on Kaplan-Meier estimates.

Number of Participants With Adverse Events (AEs) for Study Part 2From first dose to 30 days after last dosing date (assessed up to approximately 27 months)

An Adverse Event (AE) is any new untoward medical occurrence or worsening preexisting medical condition in a treated participant and that does not necessarily have a causal relationship with treatment.

An AE can be any unfavorable, unintended sign, symptom, or disease temporally associated with the use of treatment, whether or not related to the treatment.

Number of Participants With Serious Adverse Events (SAEs) for Study Part 2From first dose to 30 days after last dosing date (assessed up to approximately 27 months)

A Serious Adverse Event (SAE) results in death, is life-threatening (defined as an event in which the participant was at risk of death at the time of the event; it does not refer to an event which hypothetically might have caused death if it were more severe), or requires inpatient hospitalization or causes prolongation of existing hospitalization.

Trial Locations

Locations (35)

Local Institution - 0026

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Parma, Italy

Local Institution - 0024

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Perugia, Italy

Local Institution - 0021

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Amsterdam, Netherlands

Local Institution - 0029

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Madrid, Spain

Local Institution - 0010

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Craiova, Romania

Local Institution - 0011

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Cluj-Napoca, Cluj, Romania

Local Institution - 0017

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La Louvière, Hainaut, Belgium

Local Institution - 0007

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Greenville, South Carolina, United States

Local Institution - 0009

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Atlanta, Georgia, United States

Local Institution - 0006

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Springdale, Arkansas, United States

Local Institution - 0038

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Bronx, New York, United States

Local Institution - 0003

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Saint Louis, Missouri, United States

Local Institution - 0028

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Gent, Belgium

Local Institution - 0018

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Gent, Belgium

Local Institution - 0039

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Toulon, France

Local Institution - 0016

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Sint-Niklaas, Belgium

Local Institution - 0027

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Liege, Belgium

Local Institution - 0013

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Loewenstein, Germany

Local Institution - 0033

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Pierre Benite, France

Local Institution - 0015

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Essen, Germany

Local Institution - 0012

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Stuttgart, Germany

Local Institution - 0034

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Strasbourg Cedex, France

Local Institution - 0014

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Immenstadt, Germany

Local Institution - 0036

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Paris Cedex 5, France

Local Institution - 0023

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Bergamo, Italy

Local Institution - 0025

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Catania, Italy

Local Institution - 0022

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Nijmegen, Netherlands

Local Institution - 0032

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Sevilla, Spain

Local Institution - 0031

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Barcelona, Spain

Local Institution - 0030

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Madrid, Spain

Local Institution - 0005

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Jacksonville, Florida, United States

Local Institution - 0001

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New Haven, Connecticut, United States

Local Institution - 0002

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Cleveland, Ohio, United States

Local Institution - 0004

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Nashville, Tennessee, United States

Local Institution - 0008

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Cleveland, Ohio, United States

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