Study of Nivolumab Given Sequentially With Ipilimumab in Subjects With Advanced or Metastatic Melanoma (CheckMate 064)

Bristol-Myers Squibb (BMS)

Status and phase: Completed; Phase 2

Conditions: Advanced or Metastatic Melanoma

Treatments: Biological: Ipilimumab; Biological: Nivolumab

Study type: Interventional

Funder types: Industry

Identifiers

NCT01783938

CA209-064

Details and patient eligibility

About

The purpose of this study is to evaluate the safety and efficacy of a sequential combination therapy of Nivolumab and Ipilimumab

Full description

In order to evaluate the potential synergistic activity of nivolumab and ipilimumab and also because there may be differences in biology between tumors which are stable or responding to therapy and those that are clinically progressing, this study, CA209064, looked at two sequential combination regimens in which the second agent is administered immediately after a pre-specified duration of therapy with the first agent and not delayed until the time of progression after the first agent. This sequential study design looked at pharmacodynamic changes during treatment with one agent which may predict clinical activity to subsequent treatment with the alternate agent. This was done because it has not been scientifically proven whether or not the order in which nivolumab and ipilimumab are given is clinically important.

Enrollment: 138 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

For more information regarding BMS clinical trial participation, please visit www.BMSStudyConnect.com

Inclusion Criteria:

• Histologically confirmed unresectable Stage III or IV melanoma
• Treatment-naive or experienced disease recurrence or progression during or after one prior systemic regimen for advanced disease
• Measurable disease by Computed Tomography/Magnetic resonance imaging (CT/MRI) per Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria
• Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1
• Known BRAF V600 mutation status or consent to BRAF V600 mutation testing
• Sufficient tumor tissue accessible for baseline and post-treatment biopsies.

Exclusion Criteria:

• Active central nervous system (CNS) metastases
• Carcinomatous meningitis
• Active, known or suspected autoimmune disease
• Condition requiring systemic treatment with either corticosteroids (>10 mg daily prednisone equivalent) or other immunosuppressive medications within 14 days of randomization
• Prior therapy with anti-Programmed Death-1 (PD1), anti-Programmed Death-Ligand 1 (PD-L1), anti-PD-L2, anti-CD137, or anti-CTLA-4 (cytotoxic T lymphocyte antigen 4) antibody
• Prior treatment with other immunotherapies
• Prior therapy with BRAF inhibitor within 6 weeks of enrollment

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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138 participants in 2 patient groups

Cohort A: Nivolumab followed by Ipilimumab

Experimental group

Description:

Nivolumab 3 mg/kg solution intravenously every 2 weeks up to 6 doses in Induction period and 3 mg/kg solution intravenously every 2 weeks until disease progression, unacceptable toxicity, or withdrawal of consent in Continuation period for a maximum of 2 years from 1st study treatment in Induction Period 1. Ipilimumab 3 mg/kg solution intravenously every 3 weeks up to 4 doses in Induction period.

Treatment:

Biological: Ipilimumab

Biological: Nivolumab

Cohort B: Ipilimumab followed by Nivolumab

Experimental group

Description:

Ipilimumab 3 mg/kg solution intravenously every 3 weeks up to 4 doses in Induction period. Nivolumab 3 mg/kg solution intravenously every 2 weeks up to 6 doses in Induction period and 3 mg/kg solution intravenously every 2 weeks until disease progression, unacceptable toxicity, or withdrawal of consent in Continuation period for a maximum of 2 years from 1st study treatment in Induction Period 1.

Treatment:

Biological: Ipilimumab

Biological: Nivolumab