A Study of Nivolumab + Chemotherapy or Nivolumab + Ipilimumab Versus Chemotherapy in Non-Small Cell Lung Cancer (NSCLC) Participants With Epidermal Growth Factor Receptor (EGFR) Mutation Who Failed 1L or 2L EGFR Tyrosine Kinase Inhibitor (TKI) Therapy (CheckMate722)

Bristol-Myers Squibb (BMS)

Status and phase: Completed; Phase 3

Conditions: Non-Small-Cell Lung Carcinoma

Treatments: Drug: Cisplatin; Biological: Nivolumab; Drug: Pemetrexed; Biological: Ipilimumab; Drug: Carboplatin

Study type: Interventional

Funder types: Industry

Identifiers

NCT02864251

CA209-722

2017-002672-38 (EudraCT Number)

Details and patient eligibility

About

The main purpose of this study is to determine whether nivolumab + chemotherapy is effective as compared to chemotherapy in the treatment of patients with EGFR mutation, NSCLC who failed first line (1L) or second-line (2L) EGFR TKI therapy.

Enrollment: 367 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Confirmed stage IV or recurrent EGFR mutated NSCLC with disease progression on one or two prior lines of treatment with EGFR TKIs (allowed TKIs must be approved by the local health authority, including but not limited to erlotinib, gefitinib, afatinib, dacomitinib and osimertinib). In osimertinib treated subjects, T790 testing is not required.
• No evidence of exon 20 T790M mutation obtained at progression on prior first- or second-generation EGFR TKI therapy. For participants who were treated with osimertinib, T790M testing is not required.
• Measurable disease according to Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1)
• Available tumor sample for Programmed death-ligand 1 (PD-L1) immunohistochemical (IHC).
• Participants are eligible if central nervous system (CNS) metastases are considered to be adequately controlled/treated before or during the screening period and participants are neurologically returned to baseline (except for residual signs or symptoms related to the CNS treatment) for at least 2 weeks prior to randomization. In addition, participants must be either off corticosteroids, or on a stable or decreasing dose of ≤10 mg daily prednisone (or equivalent) for at least 2 weeks prior to randomization). Participants with asymptomatic CNS metastasis are eligible.
• Eastern Cooperative Group (ECOG) Performance Status 0-1
• Life expectancy is at least 3 months

Exclusion criteria

• Known EGFR mutation, T790M positive who failed 1L first- or second-generation TKI should receive osimertinib first as the standard of care (SOC). These participants are only eligible if they fail osimertinib as 2L.
• who have progressed within 3 months of the first dose of 1L or 2L EGFR TKI.
• Carcinomatous meningitis
• Active, known or suspected autoimmune disease are excluded
• ALK translocation
• Known SCLC transformation
• Prior treatment with an anti-PD-1, anti-PD-L1, anti-PD-L2, anti-CD137, or anti-CTLA-4 antibody, or any other antibody or drug specifically targeting T-cell co-stimulation or checkpoint pathways

Other protocol defined inclusion/exclusion criteria apply

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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367 participants in 3 patient groups

Nivolumab+Platinum doublet chemotherapy

Experimental group

Treatment:

Drug: Cisplatin

Drug: Pemetrexed

Drug: Carboplatin

Biological: Nivolumab

Nivolumab + Ipilimumab

Experimental group

Description:

Enrollment is closed for this arm

Treatment:

Biological: Ipilimumab

Biological: Nivolumab

Platinum doublet chemotherapy

Active Comparator group

Treatment:

Drug: Cisplatin

Drug: Pemetrexed

Drug: Carboplatin