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Phase 3 Trial in Subjects With Metastatic Melanoma Comparing 3 mg/kg Ipilimumab Versus 10 mg/kg Ipilimumab

A Randomized Double-Blind Phase III Study of Ipilimumab Administered at 3 mg/kg Versus at 10 mg /kg in Subjects With Previously Treated or Untreated Unresectable or Metastatic Melanoma

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01515189
Enrollment
831
Registered
2012-01-24
Start date
2012-02-17
Completion date
2017-08-17
Last updated
2019-07-31

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Melanoma

Brief summary

The purpose of this study is to determine whether giving Ipilimumab at a dose of 10mg/kg will extend the lives of subjects with unresectable or metastatic melanoma more than giving Ipilimumab at a dose of 3 mg/kg

Interventions

BIOLOGICALIpilimumab

Sponsors

Bristol-Myers Squibb
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

For more information regarding BMS clinical trial participation, please visit www.BMSStudyConnect.com. Inclusion Criteria: * Unresectable Stage III or Stage IV melanoma * Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1

Exclusion criteria

* Brain metastases with symptoms or requiring treatment * History of autoimmune disease

Design outcomes

Primary

MeasureTime frameDescription
Overall Survival (OS)Approximately 48 months (assessed up to February 2016)OS is defined for each participant as the time between randomization date and death due to any cause. The survival time for participants who had not died was censored at the last known alive date. Median and associated 2-sided 95% confidence intervals were calculated using the method of Brookmeyer and Crowley.

Secondary

MeasureTime frameDescription
Best Overall Response Rate (BORR) by mWHO CriteriaFrom date of randomization until 540 death events occurred (approximately 48 months)BORR by treatment arm was defined as the total number of randomized participants in the arm whose BOR is CR or PR, divided by the total number of randomized participants in the arm. Any participant who was unevaluable for BOR, e.g. on account of missing or not evaluable assessments, was included in the denominator of the calculation (i.e. was considered a non-responder with respect to the BORR endpoint). 95% 2-sided exact confidence intervals were computed using the method of Clopper and Pearson.
Disease Control Rate (DCR) by mWHO CriteriaFrom date of randomization until 540 death events occurred (approximately 48 months)DCR by treatment arm was defined as the total number of randomized participants in the arm whose BOR is CR, PR or SD, divided by the total number of randomized participants in the arm. Any participant who was unevaluable for Disease Control (DC), (e.g. on account of missing or not evaluable assessments), was included in the denominator of the calculation (i.e. was considered a non-responder with respect to the DCR endpoint). 95% 2-sided exact confidence intervals were computed using the Clopper and Pearson method.
Duration of Response (DOR) by mWHO CriteriaFrom date of randomization until 540 death events occurred (approximately 48 months)Duration of response for participants whose BOR was CR or PR was defined as the time between the date measurement criteria were first met for overall response of PR or CR (whichever status was recorded first) and the date of disease progression or death (whichever occurred first). For participants who underwent tumor resection following response but prior to disease progression, duration of response was censored on the date of last evaluable tumor assessment prior to resection. For participants who had BOR of SD, PR or CR at Week 12, or a confirmed response of PR or CR before Week 12, the date of PD following thereafter (where available) was used in the analysis of duration of response. For those participants who remained alive and had not progressed following response, duration of response was censored on the date of last evaluable tumor assessment. Median and associated 2-sided 95% confidence intervals were calculated using the Brookmeyer Crowley method.
Progression Free Survival (PFS) by mWHO CriteriaFrom date of randomization until 540 death events occurred (approximately 48 months)PFS was defined as the time between randomization date and the date of progression or death, whichever occurred first. A participant who died without reported prior progression was considered to have progressed on the date of death. For a participant who underwent resection post randomization, PFS was censored on last tumor assessment date prior to resection. For those who remained alive and had not progressed, PFS was censored on last evaluable tumor assessment date. Participants who had not died and had no recorded post-baseline tumor assessment were censored at the day of randomization. For participants who had Progressive Disease (PD) prior to Week 12 and a subsequent assessment of Stable Disease (SD), Partial Response (PR), or Complete Response (CR), the date of PD following response was used in the analysis of PFS; otherwise these participants were censored on the date of their last tumor assessment. Median and 2-sided 95% CIs were calculated with Brookmeyer Crowley method.
Rate of Overall SurvivalApproximately 66 monthsOS is defined for each participant as the time between randomization date and death due to any cause. The survival time for participants who had not died was censored at the last known alive date. Survival rates were calculated based on Kaplan-Meier estimation with log-log transformed confidence intervals. The survival rate at x year(s) is defined as the probability that a subject is alive at x year(s) following randomization.
Overall Survival of Participants With Brain Metastases at BaselineFrom date of randomization until 540 death events occurred (approximately 48 months)OS for each participant with brain metastases at baseline was measured as the time between randomization date and death due to any cause. The survival time for participants who had not died was censored at the last known alive date. Median OS, and associated 2-sided 95% confidence intervals were calculated using the Brookmeyer and Crowley method.
Duration of Stable Disease by mWHO CriteriaFrom date of randomization until 540 death events occurred (approximately 48 months)Duration of stable disease was defined for participants whose BOR was SD as the time between when SD was first documented and the date of PD or death (whichever occurred first). For a participant who underwent tumor resection following Week 12 but prior to disease progression, duration of stable disease was censored on the date of the last evaluable tumor assessment prior to resection. For participants who had BOR of SD at Week 12, the date of PD following thereafter (where available) was used in the analysis of duration of stable disease. For participants with BOR of SD who had not subsequently progressed and who remained alive, duration of stable disease was censored on the date of last evaluable tumor assessment. Median and associated 2-sided 95% confidence intervals were calculated using the Brookmeyer and Crowley method.

Countries

Argentina, Australia, Austria, Belgium, Canada, Czechia, Denmark, France, Germany, Hungary, Israel, Italy, Mexico, Netherlands, Norway, Poland, South Africa, Spain, Sweden, Switzerland, United Kingdom, United States

Participant flow

Pre-assignment details

831 participants were enrolled; 727 were randomized to a treatment group; 726 received at least one dose of study treatment. Of the 105 participants not treated, 81 no longer met study criteria, 11 withdrew consent, 4 suffered an Adverse Event, 4 died, and 5 were not treated due to investigator decision or other reasons.

Participants by arm

ArmCount
Ipilimumab (10 mg/kg)
Ipilimumab 10 mg/kg solution intravenously once every 3 weeks for 4 doses or until disease progression or unacceptable toxicity
365
Ipilimumab (3 mg/kg)
Ipilimumab 3 mg/kg solution intravenously once every 3 weeks for 4 doses or until disease progression or unacceptable toxicity
362
Total727

Withdrawals & dropouts

PeriodReasonFG000FG001
First Re-Induction PhaseDisease progression614
First Re-Induction PhaseNo longer meets study criteria10
First Re-Induction PhaseOther10
First Re-Induction PhaseStudy drug toxicity50
First Re-Induction PhaseWithdrawal by Subject11
InductionAdverse Event149
InductionDeath2417
InductionDisease Progression109155
InductionLost to Follow-up10
InductionNo longer meets study criteria02
InductionOther04
InductionStudy drug toxicity8636
InductionWithdrawal by Subject39

Baseline characteristics

CharacteristicIpilimumab (10 mg/kg)Ipilimumab (3 mg/kg)Total
Age, Categorical
<=18 years
0 Participants0 Participants0 Participants
Age, Categorical
>=65 years
141 Participants154 Participants295 Participants
Age, Categorical
Between 18 and 65 years
224 Participants208 Participants432 Participants
Age, Continuous58.6 years
STANDARD_DEVIATION 14.52
60.7 years
STANDARD_DEVIATION 13.22
59.7 years
STANDARD_DEVIATION 13.92
Sex: Female, Male
Female
146 Participants131 Participants277 Participants
Sex: Female, Male
Male
219 Participants231 Participants450 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
319 / 364302 / 362
serious
Total, serious adverse events
245 / 364194 / 362

Outcome results

Primary

Overall Survival (OS)

OS is defined for each participant as the time between randomization date and death due to any cause. The survival time for participants who had not died was censored at the last known alive date. Median and associated 2-sided 95% confidence intervals were calculated using the method of Brookmeyer and Crowley.

Time frame: Approximately 48 months (assessed up to February 2016)

Population: All randomized participants

ArmMeasureValue (MEDIAN)
Ipilimumab (10 mg/kg)Overall Survival (OS)15.70 months
Ipilimumab (3 mg/kg)Overall Survival (OS)11.53 months
p-value: 0.0495% CI: [0.7, 0.99]Log Rank
Secondary

Best Overall Response Rate (BORR) by mWHO Criteria

BORR by treatment arm was defined as the total number of randomized participants in the arm whose BOR is CR or PR, divided by the total number of randomized participants in the arm. Any participant who was unevaluable for BOR, e.g. on account of missing or not evaluable assessments, was included in the denominator of the calculation (i.e. was considered a non-responder with respect to the BORR endpoint). 95% 2-sided exact confidence intervals were computed using the method of Clopper and Pearson.

Time frame: From date of randomization until 540 death events occurred (approximately 48 months)

Population: All randomized participants

ArmMeasureValue (NUMBER)
Ipilimumab (10 mg/kg)Best Overall Response Rate (BORR) by mWHO Criteria15.3 percentage of participants with BORR
Ipilimumab (3 mg/kg)Best Overall Response Rate (BORR) by mWHO Criteria12.2 percentage of participants with BORR
Secondary

Disease Control Rate (DCR) by mWHO Criteria

DCR by treatment arm was defined as the total number of randomized participants in the arm whose BOR is CR, PR or SD, divided by the total number of randomized participants in the arm. Any participant who was unevaluable for Disease Control (DC), (e.g. on account of missing or not evaluable assessments), was included in the denominator of the calculation (i.e. was considered a non-responder with respect to the DCR endpoint). 95% 2-sided exact confidence intervals were computed using the Clopper and Pearson method.

Time frame: From date of randomization until 540 death events occurred (approximately 48 months)

Population: All randomized participants

ArmMeasureValue (NUMBER)
Ipilimumab (10 mg/kg)Disease Control Rate (DCR) by mWHO Criteria31.5 percentage of participants with DC
Ipilimumab (3 mg/kg)Disease Control Rate (DCR) by mWHO Criteria27.9 percentage of participants with DC
Secondary

Duration of Response (DOR) by mWHO Criteria

Duration of response for participants whose BOR was CR or PR was defined as the time between the date measurement criteria were first met for overall response of PR or CR (whichever status was recorded first) and the date of disease progression or death (whichever occurred first). For participants who underwent tumor resection following response but prior to disease progression, duration of response was censored on the date of last evaluable tumor assessment prior to resection. For participants who had BOR of SD, PR or CR at Week 12, or a confirmed response of PR or CR before Week 12, the date of PD following thereafter (where available) was used in the analysis of duration of response. For those participants who remained alive and had not progressed following response, duration of response was censored on the date of last evaluable tumor assessment. Median and associated 2-sided 95% confidence intervals were calculated using the Brookmeyer Crowley method.

Time frame: From date of randomization until 540 death events occurred (approximately 48 months)

Population: All randomized participants

ArmMeasureValue (MEDIAN)
Ipilimumab (10 mg/kg)Duration of Response (DOR) by mWHO Criteria16.33 months
Ipilimumab (3 mg/kg)Duration of Response (DOR) by mWHO Criteria15.90 months
Secondary

Duration of Stable Disease by mWHO Criteria

Duration of stable disease was defined for participants whose BOR was SD as the time between when SD was first documented and the date of PD or death (whichever occurred first). For a participant who underwent tumor resection following Week 12 but prior to disease progression, duration of stable disease was censored on the date of the last evaluable tumor assessment prior to resection. For participants who had BOR of SD at Week 12, the date of PD following thereafter (where available) was used in the analysis of duration of stable disease. For participants with BOR of SD who had not subsequently progressed and who remained alive, duration of stable disease was censored on the date of last evaluable tumor assessment. Median and associated 2-sided 95% confidence intervals were calculated using the Brookmeyer and Crowley method.

Time frame: From date of randomization until 540 death events occurred (approximately 48 months)

Population: All randomized participants

ArmMeasureValue (MEDIAN)
Ipilimumab (10 mg/kg)Duration of Stable Disease by mWHO Criteria5.55 months
Ipilimumab (3 mg/kg)Duration of Stable Disease by mWHO Criteria3.19 months
Secondary

Overall Survival of Participants With Brain Metastases at Baseline

OS for each participant with brain metastases at baseline was measured as the time between randomization date and death due to any cause. The survival time for participants who had not died was censored at the last known alive date. Median OS, and associated 2-sided 95% confidence intervals were calculated using the Brookmeyer and Crowley method.

Time frame: From date of randomization until 540 death events occurred (approximately 48 months)

Population: All randomized participants with brain metastases at baseline

ArmMeasureValue (MEDIAN)
Ipilimumab (10 mg/kg)Overall Survival of Participants With Brain Metastases at Baseline7.00 months
Ipilimumab (3 mg/kg)Overall Survival of Participants With Brain Metastases at Baseline5.67 months
95% CI: [0.49, 1.04]
Secondary

Progression Free Survival (PFS) by mWHO Criteria

PFS was defined as the time between randomization date and the date of progression or death, whichever occurred first. A participant who died without reported prior progression was considered to have progressed on the date of death. For a participant who underwent resection post randomization, PFS was censored on last tumor assessment date prior to resection. For those who remained alive and had not progressed, PFS was censored on last evaluable tumor assessment date. Participants who had not died and had no recorded post-baseline tumor assessment were censored at the day of randomization. For participants who had Progressive Disease (PD) prior to Week 12 and a subsequent assessment of Stable Disease (SD), Partial Response (PR), or Complete Response (CR), the date of PD following response was used in the analysis of PFS; otherwise these participants were censored on the date of their last tumor assessment. Median and 2-sided 95% CIs were calculated with Brookmeyer Crowley method.

Time frame: From date of randomization until 540 death events occurred (approximately 48 months)

Population: All randomized participants.

ArmMeasureValue (MEDIAN)
Ipilimumab (10 mg/kg)Progression Free Survival (PFS) by mWHO Criteria2.83 months
Ipilimumab (3 mg/kg)Progression Free Survival (PFS) by mWHO Criteria2.79 months
p-value: 0.154895% CI: [0.76, 1.04]Log Rank
Secondary

Rate of Overall Survival

OS is defined for each participant as the time between randomization date and death due to any cause. The survival time for participants who had not died was censored at the last known alive date. Survival rates were calculated based on Kaplan-Meier estimation with log-log transformed confidence intervals. The survival rate at x year(s) is defined as the probability that a subject is alive at x year(s) following randomization.

Time frame: Approximately 66 months

Population: All randomized participants

ArmMeasureGroupValue (NUMBER)
Ipilimumab (10 mg/kg)Rate of Overall SurvivalSurvival rate at 2 years38.46 percentage of participants
Ipilimumab (10 mg/kg)Rate of Overall SurvivalSurvival rate at 4 years26.63 percentage of participants
Ipilimumab (10 mg/kg)Rate of Overall SurvivalSurvival rate at 3 years31.16 percentage of participants
Ipilimumab (10 mg/kg)Rate of Overall SurvivalSurvival rate at 5 years24.90 percentage of participants
Ipilimumab (10 mg/kg)Rate of Overall SurvivalSurvival rate at 1 year54.28 percentage of participants
Ipilimumab (3 mg/kg)Rate of Overall SurvivalSurvival rate at 5 years18.78 percentage of participants
Ipilimumab (3 mg/kg)Rate of Overall SurvivalSurvival rate at 1 year47.62 percentage of participants
Ipilimumab (3 mg/kg)Rate of Overall SurvivalSurvival rate at 2 years30.97 percentage of participants
Ipilimumab (3 mg/kg)Rate of Overall SurvivalSurvival rate at 3 years23.15 percentage of participants
Ipilimumab (3 mg/kg)Rate of Overall SurvivalSurvival rate at 4 years20.25 percentage of participants

Source: ClinicalTrials.gov · Data processed: Mar 10, 2026