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Study of BMS-936558 (Nivolumab) Compared to Docetaxel in Previously Treated Metastatic Non-squamous NSCLC

An Open-Label Randomized Phase III Trial of BMS-936558 (Nivolumab) Versus Docetaxel in Previously Treated Metastatic Non-squamous Non-small Cell Lung Cancer (NSCLC)

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01673867
Acronym
CheckMate057
Enrollment
582
Registered
2012-08-28
Start date
2012-11-02
Completion date
2021-12-17
Last updated
2023-02-08

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

Conditions

Non-Squamous Cell Non-small Cell Lung Cancer

Brief summary

The purpose of the study is to compare the overall survival of BMS-936558 (Nivolumab) as compared with Docetaxel in subjects with non-squamous cell non-small cell lung cancer (NSCLC) after failure of prior platinum-based chemotherapy

Detailed description

CheckMate 057: CHECKpoint pathway and nivoluMAb clinical Trial Evaluation 057

Interventions

BIOLOGICALNivolumab
DRUGDocetaxel

Sponsors

Bristol-Myers Squibb
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

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

Inclusion criteria

* Men & women ≥18 years of age * Subjects with histologically or cytologically-documented non-squamous cell NSCLC who present with Stage IIIB/IV disease or recurrent or progressive disease following multimodal therapy (radiation therapy, surgical resection, or definitive chemoradiation therapy for locally advanced disease) and who will receive study therapy as second or third line of treatment for advanced disease * Disease recurrence or progression during/after one prior platinum doublet-based chemotherapy regimen for advanced or metastatic disease * Measurable disease by Computed tomography (CT)/Magnetic resonance imaging (MRI) per RECIST 1.1 criteria * Eastern Cooperative Oncology Group (ECOG) performance status ≤1 * A formalin fixed, paraffin-embedded (FFPE) tumor tissue block or unstained slides of tumor sample (archival or recent) must be available for biomarker evaluation. Specimens must be received by the central lab prior to randomization. Biopsy should be excisional, incisional or core needle. Fine needle aspiration is insufficient

Exclusion criteria

* Subjects with untreated central nervous system (CNS) metastases are excluded. Subjects are eligible if CNS metastases are asymptomatic or treated and subjects are neurologically returned to baseline for at least 2 weeks prior to enrollment. In addition, subjects must be either off corticosteroids, or on a stable or decreasing dose of ≤10mg daily prednisone (or equivalent) * Subjects with carcinomatous meningitis * Subjects with active or recent history of known or suspected autoimmune disease. Subjects with Type 1 diabetes mellitus, hypothyroidism only requiring hormone replacement, or skin disorders (vitiligo, psoriasis, or alopecia) not requiring systemic treatment are permitted to enroll * Subjects with a condition requiring systemic treatment with either corticosteroids or other immunosuppressive medications within 14 days of randomization * Prior therapy with anti-programmed death-1 (anti-PD-1), anti-programmed cell death ligand 1 (anti-PD-L1), anti-programmed cell death ligand 2 (anti-PD-L2), anti-cluster of differentiation 137 (anti-CD137), or anti-Cytotoxic T lymphocyte-associated antigen 4 (anti-CTLA-4) antibody (including Ipilimumab or any other antibody or drug specifically targeting T-cell co-stimulation or checkpoint pathways) * Prior treatment with Docetaxel * Treatment with any investigational agent within 14 days of first administration of study treatment Other protocol-defined inclusion/

Design outcomes

Primary

MeasureTime frameDescription
Overall Survival (OS) Time in Months for All Randomized Participants at Primary EndpointRandomization until 413 deaths, up to March 2015 (approximately 29 months)Overall survival was defined as the time from randomization to the date of death. A participant who has not died will be censored at last known date alive. OS will be followed continuously while participants are on the study drug and every 3 months via in-person or phone contact after participants discontinue the study drug. Median and hazard ratio computed using Kaplan-Meier method.

Secondary

MeasureTime frameDescription
Time To Objective Response (TTOR)From randomization to the date of first confirmed response (up to approximately 110 months)Time to Objective Response for participants demonstrating a response (either CR or PR) was defined as the time from the date of randomization to the date of the first confirmed response. CR = Disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \< 10 mm.; PR = At least a 30% decrease in the sum of diameters of target lesions, taking, as reference, the baseline sum diameters.
Duration of Objective Response (DOOR)From randomization to date of first documented tumor progression or death due to any cause, whichever occurred first (up to approximately 110 months)DOR was defined as the time from the date of first confirmed response to the date of the first documented tumor progression (per RECIST v1.1), as determined by the investigator, or death due to any cause, whichever occurred first. DOR was evaluated only for confirmed responders (i.e. participants with confirmed CR or PR). CR = Disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \< 10 mm.; PR = At least a 30% decrease in the sum of diameters of target lesions, taking, as reference, the baseline sum diameters. Participants who neither progressed nor died were censored on the date of their last evaluable tumor assessment. Median computed using Kaplan-Meier method.
Progression-Free Survival (PFS)From randomization to first confirmed response to the date of the first documented tumor progression or death due to any cause, whichever occurred first (up to approximately 110 months)PFS was defined as the time from randomization to the date of the first documented tumor progression (per RECIST 1.1) or death due to any cause. Participants who died without a reported prior progression were considered to have progressed on the date of their death. Progression will be assessed every 6 weeks (from the first on-study radiographic assessment) until disease progression is noted. Progressive disease was defined as least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. The appearance of one or more new lesions is also considered progression. Median computed using the Kaplan-Meier method.
Objective Response Rate (ORR)From randomization to date of objectively documented progression (up to approximately 110 months)ORR was defined as the percentage of participants whose Best Overall Response (BOR) was a confirmed Complete Response (CR) or Partial Response (PR). BOR was defined as the best investigator-assessed response designation, recorded between the date of randomization and the date of objectively documented progression per Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v1.1) or the date of subsequent anti-cancer therapy (excluding on-treatment palliative radiotherapy of non-target bone lesions or Central Nervous System (CNS) lesions), whichever occurred first. CR = Disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \< 10 mm. PR = At least a 30% decrease in the sum of diameters of target lesions, taking, as reference, the baseline sum diameters. CR+PR, confidence interval based on the Clopper and Pearson method.
Overall Survival (OS) by PD-L1 Expression at BaselineFrom randomization to the date of death or last known date alive (up to approximately 110 months)Overall survival was defined as the time from randomization to the date of death. A participant who has not died will be censored at last known date alive. Overall Survival time was measured in months for all randomized participants grouped by their baseline PD-L1 expression level. PD-L1 expression in participants was defined as the percent of disease tumor cells demonstrating plasma membrane PD-L1 staining of any intensity using an immunohistochemistry (IHC) assay. Median computed using the Kaplan-Meier method.
Objective Response Rate (ORR) by PD-L1 Expression at BaselineFrom randomization to date of objectively documented progression (up to approximately 110 months)ORR was defined as the percentage of all randomized participants whose Best Overall Response (BOR) was a confirmed Complete Response (CR) or Partial Response (PR). CR = Disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \< 10 mm.; PR = At least a 30% decrease in the sum of diameters of target lesions, taking, as reference, the baseline sum diameters. CR+PR, confidence interval based on the Clopper and Pearson method. ORR was reported for all randomized participants grouped by their baseline PD-L1 expression level. PD-L1 expression in participants was defined as the percent of disease tumor cells demonstrating plasma membrane PD-L1 staining of any intensity using an immunohistochemistry (IHC) assay.
Percentage of Participants Experiencing Disease-Related Symptom Improvement by Week 12Randomization to Week 12Disease-related symptom improvement rate by Week 12 was defined as the percentage of randomized participants who had a 10 point or greater decrease from baseline in average symptom burden index score at any time between randomization and Week 12. The participant portion of the Lung Cancer Symptom Scale (LCSS) consisted of 6 symptom-specific questions that addressed cough, dyspnea, fatigue, pain, hemoptysis, and anorexia, plus 3 summary items on symptom distress, interference with activity level, and global health-related Quality of Life (QoL). The scores range from 0 to 100, with 0 representing the best possible score and 100 being the worst possible score. The average symptom burden index score at each assessment was defined as the mean of the 6 symptom-specific questions of the LCSS. 95% CIs were computed using Clopper-Pearson Method.

Countries

Argentina, Australia, Austria, Brazil, Canada, Chile, Czechia, France, Germany, Hong Kong, Hungary, Italy, Mexico, Norway, Peru, Poland, Romania, Russia, Singapore, Spain, Switzerland, United States

Participant flow

Participants by arm

ArmCount
Nivolumab
Nivolumab 3 mg/kg solution administered intravenously every 2 weeks. Eligible participants transitioned to nivolumab 480 mg every 4 weeks. Participants treated until disease progression, discontinuation due to toxicity, withdrawal of consent or end of study.
292
Docetaxel
Docetaxel 75mg/m\^2 solution administered intravenously every 3 weeks. Eligible participants transitioned to nivolumab 3 mg/kg every 2 weeks or 480 mg every 4 weeks. Participants treated until disease progression, discontinuation due to toxicity, withdrawal of consent or end of study.
290
Total582

Withdrawals & dropouts

PeriodReasonFG000FG001
RandomizationAdverse event unrelated to study drug10
RandomizationLost to Follow-up01
RandomizationParticipant no longer meets study criteria45
RandomizationParticipant request to discontinue study treatment04
RandomizationWithdrawal by participant012
TreatmentAdministrative reason by sponsor30
TreatmentAdverse event unrelated to study drug2310
TreatmentDeath23
TreatmentDisease Progression208178
TreatmentMaximum clinical benefit110
TreatmentOther reason112
TreatmentParticipant no longer meets study criteria20
TreatmentParticipant request to discontinue study treatment717
TreatmentStudy Drug Toxicity2343
TreatmentWithdrawal by participant55

Baseline characteristics

CharacteristicNivolumabDocetaxelTotal
Age, Continuous60.9 years
STANDARD_DEVIATION 9.27
62.3 years
STANDARD_DEVIATION 9.75
61.6 years
STANDARD_DEVIATION 9.53
Race/Ethnicity, Customized
American Indian or Alaska Native
1 Participants0 Participants1 Participants
Race/Ethnicity, Customized
Asian
9 Participants8 Participants17 Participants
Race/Ethnicity, Customized
Black or African American
7 Participants9 Participants16 Participants
Race/Ethnicity, Customized
Hispanic or Latino
19 Participants16 Participants35 Participants
Race/Ethnicity, Customized
Native Hawaiian or Other Pacific Islander
0 Participants1 Participants1 Participants
Race/Ethnicity, Customized
Not Hispanic or Latino
135 Participants141 Participants276 Participants
Race/Ethnicity, Customized
Not Reported
138 Participants133 Participants271 Participants
Race/Ethnicity, Customized
Other
8 Participants6 Participants14 Participants
Race/Ethnicity, Customized
White
267 Participants266 Participants533 Participants
Sex: Female, Male
Female
141 Participants122 Participants263 Participants
Sex: Female, Male
Male
151 Participants168 Participants319 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
EG004
affected / at risk
deaths
Total, all-cause mortality
258 / 2922 / 15266 / 29014 / 170 / 1
other
Total, other adverse events
267 / 28712 / 15258 / 26812 / 171 / 1
serious
Total, serious adverse events
172 / 2875 / 15161 / 2689 / 171 / 1

Outcome results

Primary

Overall Survival (OS) Time in Months for All Randomized Participants at Primary Endpoint

Overall survival was defined as the time from randomization to the date of death. A participant who has not died will be censored at last known date alive. OS will be followed continuously while participants are on the study drug and every 3 months via in-person or phone contact after participants discontinue the study drug. Median and hazard ratio computed using Kaplan-Meier method.

Time frame: Randomization until 413 deaths, up to March 2015 (approximately 29 months)

Population: All randomized participants

ArmMeasureValue (MEDIAN)
NivolumabOverall Survival (OS) Time in Months for All Randomized Participants at Primary Endpoint12.19 Months
DocetaxelOverall Survival (OS) Time in Months for All Randomized Participants at Primary Endpoint9.36 Months
p-value: 0.001595.92% CI: [0.59, 0.89]Log Rank
Secondary

Duration of Objective Response (DOOR)

DOR was defined as the time from the date of first confirmed response to the date of the first documented tumor progression (per RECIST v1.1), as determined by the investigator, or death due to any cause, whichever occurred first. DOR was evaluated only for confirmed responders (i.e. participants with confirmed CR or PR). CR = Disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \< 10 mm.; PR = At least a 30% decrease in the sum of diameters of target lesions, taking, as reference, the baseline sum diameters. Participants who neither progressed nor died were censored on the date of their last evaluable tumor assessment. Median computed using Kaplan-Meier method.

Time frame: From randomization to date of first documented tumor progression or death due to any cause, whichever occurred first (up to approximately 110 months)

Population: All randomized participants who demonstrate partial response (PR) or complete response (CR)

ArmMeasureValue (MEDIAN)
NivolumabDuration of Objective Response (DOOR)17.15 Months
DocetaxelDuration of Objective Response (DOOR)5.55 Months
Secondary

Objective Response Rate (ORR)

ORR was defined as the percentage of participants whose Best Overall Response (BOR) was a confirmed Complete Response (CR) or Partial Response (PR). BOR was defined as the best investigator-assessed response designation, recorded between the date of randomization and the date of objectively documented progression per Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v1.1) or the date of subsequent anti-cancer therapy (excluding on-treatment palliative radiotherapy of non-target bone lesions or Central Nervous System (CNS) lesions), whichever occurred first. CR = Disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \< 10 mm. PR = At least a 30% decrease in the sum of diameters of target lesions, taking, as reference, the baseline sum diameters. CR+PR, confidence interval based on the Clopper and Pearson method.

Time frame: From randomization to date of objectively documented progression (up to approximately 110 months)

Population: All randomized participants

ArmMeasureValue (NUMBER)
NivolumabObjective Response Rate (ORR)19.5 Percentage of participants
DocetaxelObjective Response Rate (ORR)12.8 Percentage of participants
Secondary

Objective Response Rate (ORR) by PD-L1 Expression at Baseline

ORR was defined as the percentage of all randomized participants whose Best Overall Response (BOR) was a confirmed Complete Response (CR) or Partial Response (PR). CR = Disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \< 10 mm.; PR = At least a 30% decrease in the sum of diameters of target lesions, taking, as reference, the baseline sum diameters. CR+PR, confidence interval based on the Clopper and Pearson method. ORR was reported for all randomized participants grouped by their baseline PD-L1 expression level. PD-L1 expression in participants was defined as the percent of disease tumor cells demonstrating plasma membrane PD-L1 staining of any intensity using an immunohistochemistry (IHC) assay.

Time frame: From randomization to date of objectively documented progression (up to approximately 110 months)

Population: All randomized participants who had a tumor biopsy assessed for PD-L1 expression

ArmMeasureGroupValue (NUMBER)
NivolumabObjective Response Rate (ORR) by PD-L1 Expression at BaselineParticipants with baseline PD-L1 expression ≥ 5%36.2 Percentage of participants
NivolumabObjective Response Rate (ORR) by PD-L1 Expression at BaselineParticipants with baseline PD-L1 expression < 5%10.9 Percentage of participants
DocetaxelObjective Response Rate (ORR) by PD-L1 Expression at BaselineParticipants with baseline PD-L1 expression ≥ 5%12.8 Percentage of participants
DocetaxelObjective Response Rate (ORR) by PD-L1 Expression at BaselineParticipants with baseline PD-L1 expression < 5%14.5 Percentage of participants
Secondary

Overall Survival (OS) by PD-L1 Expression at Baseline

Overall survival was defined as the time from randomization to the date of death. A participant who has not died will be censored at last known date alive. Overall Survival time was measured in months for all randomized participants grouped by their baseline PD-L1 expression level. PD-L1 expression in participants was defined as the percent of disease tumor cells demonstrating plasma membrane PD-L1 staining of any intensity using an immunohistochemistry (IHC) assay. Median computed using the Kaplan-Meier method.

Time frame: From randomization to the date of death or last known date alive (up to approximately 110 months)

Population: All randomized participants who had a tumor biopsy assessed for PD-L1 expression

ArmMeasureGroupValue (MEDIAN)
NivolumabOverall Survival (OS) by PD-L1 Expression at BaselineParticipants with baseline PD-L1 expression ≥ 5%19.91 Months
NivolumabOverall Survival (OS) by PD-L1 Expression at BaselineParticipants with baseline PD-L1 expression < 5%9.86 Months
DocetaxelOverall Survival (OS) by PD-L1 Expression at BaselineParticipants with baseline PD-L1 expression ≥ 5%8.11 Months
DocetaxelOverall Survival (OS) by PD-L1 Expression at BaselineParticipants with baseline PD-L1 expression < 5%10.28 Months
Secondary

Percentage of Participants Experiencing Disease-Related Symptom Improvement by Week 12

Disease-related symptom improvement rate by Week 12 was defined as the percentage of randomized participants who had a 10 point or greater decrease from baseline in average symptom burden index score at any time between randomization and Week 12. The participant portion of the Lung Cancer Symptom Scale (LCSS) consisted of 6 symptom-specific questions that addressed cough, dyspnea, fatigue, pain, hemoptysis, and anorexia, plus 3 summary items on symptom distress, interference with activity level, and global health-related Quality of Life (QoL). The scores range from 0 to 100, with 0 representing the best possible score and 100 being the worst possible score. The average symptom burden index score at each assessment was defined as the mean of the 6 symptom-specific questions of the LCSS. 95% CIs were computed using Clopper-Pearson Method.

Time frame: Randomization to Week 12

Population: All randomized participants

ArmMeasureValue (NUMBER)
NivolumabPercentage of Participants Experiencing Disease-Related Symptom Improvement by Week 1217.8 Percentage of participants
DocetaxelPercentage of Participants Experiencing Disease-Related Symptom Improvement by Week 1219.7 Percentage of participants
Secondary

Progression-Free Survival (PFS)

PFS was defined as the time from randomization to the date of the first documented tumor progression (per RECIST 1.1) or death due to any cause. Participants who died without a reported prior progression were considered to have progressed on the date of their death. Progression will be assessed every 6 weeks (from the first on-study radiographic assessment) until disease progression is noted. Progressive disease was defined as least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. The appearance of one or more new lesions is also considered progression. Median computed using the Kaplan-Meier method.

Time frame: From randomization to first confirmed response to the date of the first documented tumor progression or death due to any cause, whichever occurred first (up to approximately 110 months)

Population: All randomized participants

ArmMeasureValue (MEDIAN)
NivolumabProgression-Free Survival (PFS)2.33 Months
DocetaxelProgression-Free Survival (PFS)4.44 Months
Secondary

Time To Objective Response (TTOR)

Time to Objective Response for participants demonstrating a response (either CR or PR) was defined as the time from the date of randomization to the date of the first confirmed response. CR = Disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \< 10 mm.; PR = At least a 30% decrease in the sum of diameters of target lesions, taking, as reference, the baseline sum diameters.

Time frame: From randomization to the date of first confirmed response (up to approximately 110 months)

Population: All randomized participants who demonstrate partial response (PR) or complete response (CR)

ArmMeasureValue (MEDIAN)
NivolumabTime To Objective Response (TTOR)2.10 Months
DocetaxelTime To Objective Response (TTOR)2.73 Months
Post Hoc

Overall Survival (OS) - Extended Collection

Overall survival was defined as the time from randomization to the date of death. A participant who has not died will be censored at last known date alive. OS will be followed continuously while participants are on the study drug and every 3 months via in-person or phone contact after participants discontinue the study drug. Median computed using Kaplan-Meier method. Note: This outcome measure represents an updated version of the primary endpoint to include additional data collection that has occurred after the primary completion date. (Assessments were made until December 17, 2021).

Time frame: From randomization to the date of death or last known date alive (up to approximately 110 months)

Population: All randomized participants

ArmMeasureValue (MEDIAN)
NivolumabOverall Survival (OS) - Extended Collection12.21 Months
DocetaxelOverall Survival (OS) - Extended Collection9.49 Months

Source: ClinicalTrials.gov · Data processed: Mar 23, 2026