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纳武利尤单抗联合伊匹单抗治疗晚期黑色素瘤日本患者的疗效和安全性:一项开放标签、单臂、多中心 II 期研究。

Efficacy and safety of nivolumab in combination with ipilimumab in Japanese patients with advanced melanoma: An open-label, single-arm, multicentre phase II study.

机构信息

Department of Dermatologic Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.

Dermatology Division, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka 411-8777, Japan.

出版信息

Eur J Cancer. 2018 Dec;105:114-126. doi: 10.1016/j.ejca.2018.09.025. Epub 2018 Nov 15.

DOI:10.1016/j.ejca.2018.09.025
PMID:30447539
Abstract

AIM

The aim of the study was to evaluate the efficacy and safety of nivolumab combined with ipilimumab in treatment-naïve Japanese patients with advanced melanoma.

METHODS

In this multicentre, single-arm study, treatment-naïve Japanese patients with unresectable stage III/IV or recurrent melanoma received nivolumab (1 mg/kg) plus ipilimumab (3 mg/kg) every 3 weeks for four doses, followed by biweekly doses of nivolumab (3 mg/kg). The primary end-point was centrally assessed objective response rate (ORR). Secondary end-points included overall survival (OS), progression-free survival (PFS), disease control rate and safety.

RESULTS

The subtypes of the thirty patients enrolled were: 12, mucosal; eight, non-acral cutaneous; seven, acral; two, uveal and one, unknown primary melanoma. The ORR was 43.3% (95% confidence interval [CI]: 25.5, 62.6) with central and local assessment. The centrally and locally assessed disease control rate (95% CI) were 73.3% (54.1, 87.7) and 86.7% (69.3, 96.2), respectively. At the median follow-up period of 14.1 months (range 5.2-27.7), median OS and centrally assessed PFS were not reached. OS (95% CI) at 6, 12, 18 and 24 months was 93.3% (75.9, 98.3), 83.3% (64.5, 92.7), 72.9% (50.0, 86.5) and 65.6% (40.4, 82.2), respectively. Treatment-related adverse events (AEs) occurred in all patients. Grade III-IV and serious AEs occurred, mostly during the combination phase, in 23 (76.7%) and 20 (66.7%) patients, respectively. No treatment-related deaths occurred.

CONCLUSIONS

This study confirmed the efficacy and safety of nivolumab plus ipilimumab in treatment-naïve Japanese patients with advanced melanoma including rare subtypes. Incidence rates for grade III-IV AEs were high but manageable with appropriate medical attention and treatment.

TRIAL REGISTRATION

JapicCTI-152869.

摘要

目的

本研究旨在评估纳武利尤单抗联合伊匹单抗在未经治疗的日本晚期黑色素瘤患者中的疗效和安全性。

方法

在这项多中心、单臂研究中,未经治疗的不可切除 III/IV 期或复发性黑色素瘤日本患者接受纳武利尤单抗(1mg/kg)联合伊匹单抗(3mg/kg)每 3 周给药 4 次,随后每 2 周给予纳武利尤单抗(3mg/kg)。主要终点是中心评估的客观缓解率(ORR)。次要终点包括总生存期(OS)、无进展生存期(PFS)、疾病控制率和安全性。

结果

纳入的 30 名患者的亚型为:12 名黏膜黑色素瘤,8 名非肢端皮肤黑色素瘤,7 名肢端黑色素瘤,2 名葡萄膜黑色素瘤和 1 名未知原发性黑色素瘤。ORR 为 43.3%(95%置信区间[CI]:25.5,62.6),包括中心和局部评估。中心和局部评估的疾病控制率(95%CI)分别为 73.3%(54.1,87.7)和 86.7%(69.3,96.2)。在中位随访 14.1 个月(5.2-27.7)时,中位 OS 和中心评估的 PFS 尚未达到。6、12、18 和 24 个月时的 OS(95%CI)分别为 93.3%(75.9,98.3)、83.3%(64.5,92.7)、72.9%(50.0,86.5)和 65.6%(40.4,82.2)。所有患者均发生治疗相关不良事件(AE)。3 级或 4 级和严重 AE 分别发生在 23 名(76.7%)和 20 名(66.7%)患者中,主要发生在联合治疗期。无治疗相关死亡。

结论

本研究证实了纳武利尤单抗联合伊匹单抗在未经治疗的日本晚期黑色素瘤患者中的疗效和安全性,包括罕见亚型。3 级或 4 级 AE 的发生率较高,但通过适当的医疗关注和治疗是可以控制的。

临床试验注册

JapicCTI-152869。

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