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BMS' blockbuster Opdivo flies high and falls short in non-small cell lung cancer

Published on 25/07/19 at 11:38am

Bristol-Myers Squibb has pulled back the veil on new data from two analyses of its blockbuster immunotherapy Opdivo (nivolumab) in the first-line treatment of non-small cell lung cancer (NSCLC), and not all of it was positive.

In the first of two announcements, it was revealed that, in part 1a of a Phase 3 trial, Opdivo in combination with low-dose Yervoy (ipilimumab) outmatched chemotherapy in improving overall survival (OS) in first-line NSCLC patients whose tumours expressed PD-L1 ≥1%, meeting the trial’s co-primary endpoint. In part 1b of the trial, a similar survival benefit  was observed in patients whose tumours did not express PD-L1.

“CheckMate-227 is the first Phase 3 trial to demonstrate that patients with lung cancer can achieve superior overall survival with a dual immunotherapy combination versus chemotherapy,” said Dr Fouad Namouni, Head of Oncology Development at Bristol-Myers Squibb. “Lung cancer is the third tumour type where the Opdivo plus Yervoy regimen has shown a significant overall survival benefit in a randomised Phase 3 trial, reinforcing the importance of Yervoy in the treatment of cancer. We thank the patients and investigators who participated in this trial.”

However, in a second announcement, BMS revealed that the therapy failed to extend the same benefit of overall survival when used in combination with chemotherapy in patients with first-line non-squamous NSCLC, regardless of PD-L1 status.

Specifically, the combo improved median OS by 18.83 months, compared to 15.57 for chemo alone, while OS after one year of treatment stood at 67.3% compared to 59.2%. Performance was slightly better in an exploratory analysis of first-line squamous NSCLC patients, where median OS was 18.27 months compared to 11.96 for chemo alone.

“While this is not the outcome we had hoped for, the Opdivo plus chemotherapy one-year landmark overall survival in the non-squamous population was consistent with the experimental arms in previously-reported trials of IO/chemotherapy combination regimens,” remarked Dr Namouni. “We thank the patients and investigators who participated in this trial.”

The company confirmed that it would be sharing full results from the two studies at an upcoming medical meeting, while the first set of results is being submitted to regulators.

Matt Fellows

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