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Opdivo (nivolumab) demonstrates high overall response rate of 87% for treatment of relapsed or refractory Hodgkin Lymphoma

Posted: 8 December 2014 |

Bristol-Myers Squibb Company announced positive results from a cohort of patients in its ongoing Phase 1b trial (CheckMate -039) which evaluated PD-1 immune checkpoint inhibitor, Opdivo (nivolumab), in patients with relapsed or refractory hematological malignancies (n=23)…

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Bristol-Myers Squibb Company (NYSE:BMY) today announced positive results from a cohort of patients in its ongoing Phase 1b trial (CheckMate -039) which evaluated PD-1 immune checkpoint inhibitor, Opdivo (nivolumab), in patients with relapsed or refractory hematological malignancies (n=23). Results showed high levels of response in patients with relapsed or refractory classical Hodgkin Lymphoma (HL), with an overall response rate of 87% (n=20) and stable disease in 13% (n=3). These findings were published today in The New England Journal of Medicine (NEJM) and highlighted in the press briefing on Saturday, December 6 during the 56th annual meeting of the American Society for Hematology (Abstract #289).

In patients with HL, initial treatment typically consists of chemotherapy and/or radiation therapy, followed by an autologous stem cell transplant (ASCT) if the disease recurs. For those who relapse within one year after receiving a standard of care like ASCT, the median survival is only 1.3 years after progression.

“Despite the current treatment landscape, this patient population is still experiencing relatively short-lived responses that often result in relapse. So, there is a critical need to identify new options that can improve outcomes during the course of their care,” said Philippe Armand, M.D., Ph.D, medical oncologist, Dana-Farber Cancer Institute and Associate Professor, Department of Medicine, Harvard Medical School. “These findings with Opdivo are incredibly encouraging because they show that an immuno-oncology approach with a check point blockade has the potential to be applied to lymphomas.”

CheckMate -039 results support the first Breakthrough Therapy Designation for Opdivo, granted in May 2014 by the U.S. Food and Drug Administration (FDA) for the treatment of patients with HL after failure of autologous stem cell transplant and brentuximab.

“Bristol-Myers Squibb has a long standing commitment to the treatment of hematologic cancers, and we continue to advance potential treatment options for this patient population through our leadership in Immuno-Oncology,” said Michael Giordano, senior vice president, Head of Development, Oncology, Bristol-Myers Squibb. “These new data from Opdivo represent the next step towards our goal of identifying therapies that can transform the standard of care across a variety of cancer types.”

On Monday, December 8, additional results from CheckMate -039 will be highlighted in a separate oral presentation (Abstract #291) that could support the potential of Opdivo to treat patients with relapsed or refractory non-Hodgkin lymphoma. This ongoing Phase 1 trial is also exploring the combination of Opdivo and Yervoy in hematologic malignancies. Data from that arm of the study will be published at a later date.

Bristol-Myers Squibb has proposed the name Opdivo (pronounced op-dee-voh), which, if approved by health authorities, will serve as the trademark for nivolumab.

About CheckMate -039

CheckMate -039 is an ongoing Phase 1 dose escalation study of patients with relapsed and refractory hematological malignancies, which includes a cohort evaluating Opdivo in patients with HL after failure of autologous stem cell transplant and brentuximab. The cohort includes 23 patients who were treated with Opdivo 3 mg/kg at week one, week four and every two weeks until disease progression or complete response or for a maximum of two years. The primary endpoints included evaluating the safety and tolerability of Opdivo. Secondary endpoints included determining antitumor activity, characterizing Opdivo pharmacokinetics and immunogenicity, and assessing PD-L1 and PD-L2 expression as a predictive biomarker.

In the trial, 87% (n=20) achieved an overall response, with 17% (n=4) achieving complete response and 70% (n=16) a partial response. The remaining patients, 13% (n=3), experienced stable disease. Of the patients who achieved a complete and partial response, 60% (n=12) had their first response within eight weeks (range: 3-39 weeks). Data from the study also showed a progression-free survival rate of 86% at 24 weeks, meaning patients lived six months longer without their disease worsening.

Safety results were reported in all patients treated in the study. Overall, drug-related adverse events of any grade were reported in 78% of patients (n=18), with the most common being rash (22%) and decreased platelet count (17%). Of these, Grade 3 adverse events occurred in 22% of patients (n=5). There were no treatment-related Grade 4 or 5 adverse events.

About Opdivo

Cancer cells may exploit “regulatory” pathways, such as checkpoint pathways, to hide from the immune system and shield the tumor from immune attack. Opdivo is an investigational, fully-human PD-1 immune checkpoint inhibitor that binds to the checkpoint receptor PD-1 (programmed death-1) expressed on activated T-cells.

Bristol-Myers Squibb has a broad, global development program to study Opdivo in multiple tumor types consisting of more than 50 trials – as monotherapy or in combination with other therapies – in which more than 7,000 patients have been enrolled worldwide. Among these are several potentially registrational trials in non-small cell lung cancer (NSCLC), melanoma, renal cell carcinoma (RCC), head and neck cancer, glioblastoma and non-Hodgkin lymphoma.

In 2012, the FDA granted Fast Track designation for Opdivo in NSCLC, melanoma and RCC. In April 2014, the company initiated a rolling submission with the FDA for Opdivo in third-line pre-treated squamous cell NSCLC and expects to complete the submission by year-end. The FDA granted Opdivo Breakthrough Therapy Designation in May 2014 for the treatment of patients with Hodgkin lymphoma after failure of autologous stem cell transplant and brentuximab. On July 4, Ono Pharmaceutical Co. announced that Opdivo received manufacturing and marketing approval in Japan for the treatment of patients with unresectable melanoma, making Opdivo the first PD-1 immune checkpoint inhibitor to receive regulatory approval anywhere in the world. On September 26, Bristol-Myers Squibb announced that the FDA accepted for priority review the Biologics License Application for previously treated advanced melanoma, and the Prescription Drug User Fee Act goal date for a decision is March 30, 2015. The FDA also granted Opdivo Breakthrough Therapy status for this indication. In the European Union, the European Medicines Agency (EMA) has validated for review the Marketing Authorization Application for Opdivo in advanced melanoma. The application has also been granted accelerated assessment by the EMA’s CHMP. The EMA also validated for review the MAA for nivolumab in NSCLC.

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