CheckMate 920 (NCT02982954) is a multicohort, phase 3b/4 clinical trial of nivolumab plus ipilimumab treatment in predominantly US community-based patients with previously untreated advanced renal cell carcinoma (RCC) and clinical features mostly excluded from phase 3 trials. We report safety and efficacy results from the advanced non-clear cell RCC (nccRCC) cohort of CheckMate 920.
Patients with previously untreated advanced/metastatic nccRCC, Karnofsky performance status ≥70%, and any International Metastatic Renal Cell Carcinoma Database Consortium risk received up to four doses of nivolumab 3 mg/kg plus ipilimumab 1 mg/kg every 3 weeks followed by nivolumab 480 mg every 4 weeks for ≤2 years or until disease progression/unacceptable toxicity. The primary endpoint was incidence of grade ≥3 immune-mediated adverse events (AEs) within 100 days of last dose of study drug. Key secondary endpoints included objective response rate (ORR), progression-free survival (PFS; both investigator-assessed), time to response (TTR), and duration of response (DOR), all using RECIST V.1.1. Overall survival (OS) was exploratory.
Fifty-two patients with nccRCC (unclassified histology, 42.3%; papillary, 34.6%; chromophobe, 13.5%; translocation-associated, 3.8%; collecting duct, 3.8%; renal medullary, 1.9%) received treatment. With 24.1 months minimum study follow-up, median duration of therapy (range) was 3.5 (0.0-25.8) months for nivolumab and 2.1 (0.0-3.9) months for ipilimumab. Median (range) number of doses received was 4.5 (1-28) for nivolumab and 4.0 (1-4) for ipilimumab. Grade 3-4 immune-mediated AEs were diarrhea/colitis (7.7%), rash (5.8%), nephritis and renal dysfunction (3.8%), hepatitis (1.9%), adrenal insufficiency (1.9%), and hypophysitis (1.9%). No grade 5 immune-mediated AEs occurred. ORR (n=46) was 19.6% (95% CI 9.4 to 33.9). Two patients achieved complete response (papillary, n=1; unclassified, n=1), seven achieved partial response (papillary, n=4; unclassified, n=3), and 17 had stable disease. Median TTR was 2.8 (range 2.1-14.8) months. Median DOR was not reached (range 0.0+-27.8+); eight of nine responders remain without reported progression. Median PFS (n=52) was 3.7 (95% CI 2.7 to 4.6) months. Median OS (n=52) was 21.2 (95% CI 16.6 to not estimable) months.
Nivolumab plus ipilimumab for previously untreated advanced nccRCC showed no new safety signals and encouraging antitumor activity.
NCT02982954.
Journal for immunotherapy of cancer. 2022 Feb [Epub]
Scott S Tykodi, Lucio N Gordan, Robert S Alter, Edward Arrowsmith, Michael R Harrison, Ivor Percent, Rakesh Singal, Peter Van Veldhuizen, Daniel J George, Thomas Hutson, Joshua Zhang, Jesus Zoco, Jennifer L Johansen, Arash Rezazadeh Kalebasty
Division of Medical Oncology, University of Washington, Seattle, Washington, USA stykodi@fredhutch.org., Florida Cancer Specialists, Gainesville, Florida, USA., John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, New Jersey, USA., Sarah Cannon Research Institute/Tennessee Oncology, PLLC, Chattanooga, Tennessee, USA., Duke Cancer Institute Center for Prostate and Urologic Cancers, Durham, North Carolina, USA., Florida Cancer Specialists, Port Charlotte, Florida, USA., Sylvester Comprehensive Cancer Center, Miami, Florida, USA., Department of Medicine, University of Rochester Medical Center, Rochester, New York, USA., Texas A&M University College of Medicine, Bryan, Texas, USA., Department of Clinical Research, Bristol Myers Squibb, Princeton, New Jersey, USA., Syneos Health, Braine l'Alleud, Belgium., US Medical Immunology & Fibrosis, Bristol Myers Squibb, Princeton, New Jersey, USA., Norton Cancer Institute, Norton Healthcare, Louisville, Kentucky, USA.