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Study of Nivolumab (BMS-936558) Plus Ipilimumab Compared With Ipilimumab Alone in the Treatment of Previously Untreated, Unresectable, or Metastatic Melanoma

Phase 2, Randomized, Double Blinded, Study of Nivolumab (BMS-936558) in Combination With Ipilimumab vs Ipilimumab Alone in Subjects With Previously Untreated, Unresectable or Metastatic Melanoma

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01927419
Acronym
CheckMate 069
Enrollment
142
Registered
2013-08-22
Start date
2013-08-23
Completion date
2021-02-26
Last updated
2022-03-18

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

Conditions

Metastatic Melanoma, Unresectable Melanoma

Brief summary

The primary purpose of this study is to compare the objective response rate, as determined by investigators, of Nivolumab combined with Ipilimumab versus Ipilimumab monotherapy in patients with untreated, unresectable, or metastatic melanoma

Interventions

DRUGNivolumab
DRUGIpilimumab
DRUGPlacebo

Matching nivolumab

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 Key Inclusion Criteria: * Eastern Cooperative Oncology Group performance status of 0 or 1 * Histologically confirmed unresectable Stage III or Stage IV melanoma * No prior systemic anticancer therapy for unresectable or metastatic melanoma. Note that prior adjuvant or neoadjuvant melanoma therapy is permitted if it was completed at least 6 weeks prior to date of first dose, and all related adverse events have either returned to baseline or stabilized * Tumor tissue obtained in the metastatic setting or from an unresectable site must be provided for biomarker analyses and sent to the central laboratory. Biopsy should be excisional, incisional punch, or core needle. Fine needle aspirates or other cytology samples are insufficient * Known BRAF V600 mutation status as determined by an FDA-approved test. Patients with either V600 wild-type or V600 mutation-positive melanoma are eligible. Key

Exclusion criteria

* Active brain metastases or leptomeningeal metastases. Patients with treated brain metastases are eligible if there is no evidence of progression on magnetic resonance imaging scan for at least 8 weeks after completion of treatment and within 28 days prior to first dose of study drug administration. There must also be no requirement for high doses of systemic corticosteroids that could result in immunosuppression (\>10 mg/day prednisone equivalents) for at least 2 weeks prior to study drug administration * Ocular melanoma * Patients with active, known, or suspected autoimmune disease. Those with vitiligo, type I diabetes mellitus, residual hypothyroidism due to autoimmune condition only requiring hormone replacement, psoriasis not requiring systemic treatment, or conditions not expected to recur in the absence of an external trigger are permitted to enroll.

Design outcomes

Primary

MeasureTime frameDescription
Objective Response Rate (ORR) - BRAF Wild-type (WT) ParticipantsFrom 12 weeks after Randomization, assessed every 6 weeks up to Week 49 of study treatment and then every 12 weeks until disease progression (up to approximately 76 months)Objective Response Rate is defined as the percentage of participants with a best overall response of Complete Response (CR) or Partial Response (PR), assessed by the investigator by using RECIST 1.1 criteria. CR=all target and nontarget lesions have disappeared. Lymph nodes selected must have returned to normal size (\<10 mm). PR=at least a 30% decrease in the sum of the longest diameter (LD) of target lesions, taking as reference the baseline sum LD.

Secondary

MeasureTime frameDescription
Progression-Free Survival (PFS) - BRAF Wild-type (WT) ParticipantsFrom randomization to progression or death (up to approximately 88 months)PFS is defined as the time between the date of randomization and the first date of documented progression, as assessed by the investigator, or death due to any cause, whichever occurs first. Participants who died without a reported progression were considered to have progressed on the date of their death. Participants who did not progress or died were censored on the date of their last evaluable tumor assessment. PFS values are based on Kaplan-Meier Estimates.
Objective Response Rate (ORR) - BRAF Mutant ParticipantsFrom 12 weeks after Randomization, assessed every 6 weeks up to Week 49 of study treatment and then every 12 weeks until disease progression (up to approximately 76 months)Objective Response Rate is defined as the percentage of participants with a best overall response of Complete Response (CR) or Partial Response (PR), assessed by the investigator by using RECIST 1.1 criteria. CR=all target and nontarget lesions have disappeared. Lymph nodes selected must have returned to normal size (\<10 mm). PR=at least a 30% decrease in the sum of the longest diameter (LD) of target lesions, taking as reference the baseline sum LD.
Progression-Free Survival (PFS) - BRAF Mutant ParticipantsFrom randomization to progression or death (up to approximately 88 months)PFS is defined as the time between the date of randomization and the first date of documented progression, as assessed by the investigator, or death due to any cause, whichever occurs first. Participants who died without a reported progression were considered to have progressed on the date of their death. Participants who did not progress or died were censored on the date of their last evaluable tumor assessment. PFS values are based on Kaplan-Meier Estimates.
Change From Baseline in European Organization for Research and Treatment of Cancer (EORTC) Overall Quality of Life (QOL) C30 ScoreFrom Baseline (prior to start of study treatment) to Week 25 after first doseThe EORTC QLQ-C30 version 3 is a questionnaire developed to assess the QOL of cancer patients. The questionnaire is a 30-item tool, and it comprises 6 functional subscales (physical functioning, role functioning, cognitive functioning, emotional functioning, social functioning and global quality of life) as well as 9 symptom subscales (fatigue, pain, nausea/vomiting, dyspnea, insomnia, appetite loss, constipation, diarrhea, and financial difficulties). Scores for each subscale range from 0 to 100. For the 6 functional subscales, a higher score represents a better level of functioning/health status. For the 9 symptom subscales, a lower score represents a better outcome (low level of symptomatology). Scores for the 15 subscales are presented individually.

Countries

France, United States

Participant flow

Pre-assignment details

142 participants were randomized, and 140 participants received treatment.

Participants by arm

ArmCount
Nivolumab + Ipilimumab
Participants received 1 mg/kg of nivolumab + 3 mg/kg of ipilimumab solution intravenously every 3 weeks for 4 doses (4 cycles), then 3 mg/kg of nivolumab intravenously every 2 weeks until documented disease progression, toxicity, withdrawal of consent, or study completion.
95
Ipilimumab
Participants received placebo-matching nivolumab + 3 mg/kg of ipilimumab solution intravenously every 3 weeks for 4 doses (4 cycles), then placebo-matching nivolumab solution intravenously every 2 weeks until documented disease progression, toxicity, withdrawal of consent, or study completion.
47
Total142

Withdrawals & dropouts

PeriodReasonFG000FG001
Pre-Treatment PeriodAdverse event unrelated to study drug01
Pre-Treatment PeriodParticipants no longer meeting study criteria10
Treatment PeriodAdverse event unrelated to study drug63
Treatment PeriodDeath01
Treatment PeriodDisease progression1720
Treatment PeriodMaximum Clinical Benefit62
Treatment PeriodNot Reported11
Treatment PeriodOther reasons34
Treatment PeriodParticipant request to discontinue124
Treatment PeriodStudy drug toxicity4810
Treatment PeriodWithdrawal by Subject11

Baseline characteristics

CharacteristicNivolumab + IpilimumabIpilimumabTotal
Age, Continuous63.3 Years
STANDARD_DEVIATION 11
64.5 Years
STANDARD_DEVIATION 10.2
63.7 Years
STANDARD_DEVIATION 10.7
Age, Customized
65 years and older to younger than 75 years
35 Participants22 Participants57 Participants
Age, Customized
75 years and older
12 Participants5 Participants17 Participants
Age, Customized
Younger than 65 years
48 Participants20 Participants68 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
1 Participants0 Participants1 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
82 Participants43 Participants125 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
12 Participants4 Participants16 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
1 Participants0 Participants1 Participants
Race (NIH/OMB)
Black or African American
0 Participants0 Participants0 Participants
Race (NIH/OMB)
More than one race
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
2 Participants0 Participants2 Participants
Race (NIH/OMB)
White
92 Participants47 Participants139 Participants
Sex: Female, Male
Female
32 Participants15 Participants47 Participants
Sex: Female, Male
Male
63 Participants32 Participants95 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
44 / 9429 / 46
other
Total, other adverse events
90 / 9445 / 46
serious
Total, serious adverse events
69 / 9427 / 46

Outcome results

Primary

Objective Response Rate (ORR) - BRAF Wild-type (WT) Participants

Objective Response Rate is defined as the percentage of participants with a best overall response of Complete Response (CR) or Partial Response (PR), assessed by the investigator by using RECIST 1.1 criteria. CR=all target and nontarget lesions have disappeared. Lymph nodes selected must have returned to normal size (\<10 mm). PR=at least a 30% decrease in the sum of the longest diameter (LD) of target lesions, taking as reference the baseline sum LD.

Time frame: From 12 weeks after Randomization, assessed every 6 weeks up to Week 49 of study treatment and then every 12 weeks until disease progression (up to approximately 76 months)

Population: All randomized BRAF wild-type participants .

ArmMeasureValue (NUMBER)
Nivolumab + IpilimumabObjective Response Rate (ORR) - BRAF Wild-type (WT) Participants60.3 Percentage of participants
IpilimumabObjective Response Rate (ORR) - BRAF Wild-type (WT) Participants10.8 Percentage of participants
95% CI: [31.4, 61.8]Fisher Exact
95% CI: [3.79, 52.55]Fisher Exact
Secondary

Change From Baseline in European Organization for Research and Treatment of Cancer (EORTC) Overall Quality of Life (QOL) C30 Score

The EORTC QLQ-C30 version 3 is a questionnaire developed to assess the QOL of cancer patients. The questionnaire is a 30-item tool, and it comprises 6 functional subscales (physical functioning, role functioning, cognitive functioning, emotional functioning, social functioning and global quality of life) as well as 9 symptom subscales (fatigue, pain, nausea/vomiting, dyspnea, insomnia, appetite loss, constipation, diarrhea, and financial difficulties). Scores for each subscale range from 0 to 100. For the 6 functional subscales, a higher score represents a better level of functioning/health status. For the 9 symptom subscales, a lower score represents a better outcome (low level of symptomatology). Scores for the 15 subscales are presented individually.

Time frame: From Baseline (prior to start of study treatment) to Week 25 after first dose

Population: All randomized participants with available measurements at baseline and week 25

ArmMeasureGroupValue (MEAN)Dispersion
Nivolumab + IpilimumabChange From Baseline in European Organization for Research and Treatment of Cancer (EORTC) Overall Quality of Life (QOL) C30 ScoreNausea and Vomiting-3.03 Score on a scaleStandard Deviation 12.211
Nivolumab + IpilimumabChange From Baseline in European Organization for Research and Treatment of Cancer (EORTC) Overall Quality of Life (QOL) C30 ScoreEmotional Functioning8.33 Score on a scaleStandard Deviation 10.603
Nivolumab + IpilimumabChange From Baseline in European Organization for Research and Treatment of Cancer (EORTC) Overall Quality of Life (QOL) C30 ScorePain-2.27 Score on a scaleStandard Deviation 12.905
Nivolumab + IpilimumabChange From Baseline in European Organization for Research and Treatment of Cancer (EORTC) Overall Quality of Life (QOL) C30 ScoreFatigue-3.54 Score on a scaleStandard Deviation 21.52
Nivolumab + IpilimumabChange From Baseline in European Organization for Research and Treatment of Cancer (EORTC) Overall Quality of Life (QOL) C30 ScoreDyspnea-9.09 Score on a scaleStandard Deviation 23.417
Nivolumab + IpilimumabChange From Baseline in European Organization for Research and Treatment of Cancer (EORTC) Overall Quality of Life (QOL) C30 ScoreInsomnia-12.12 Score on a scaleStandard Deviation 31.782
Nivolumab + IpilimumabChange From Baseline in European Organization for Research and Treatment of Cancer (EORTC) Overall Quality of Life (QOL) C30 ScoreCognitive Functioning-1.52 Score on a scaleStandard Deviation 15.352
Nivolumab + IpilimumabChange From Baseline in European Organization for Research and Treatment of Cancer (EORTC) Overall Quality of Life (QOL) C30 ScoreAppetite Loss-13.64 Score on a scaleStandard Deviation 30.271
Nivolumab + IpilimumabChange From Baseline in European Organization for Research and Treatment of Cancer (EORTC) Overall Quality of Life (QOL) C30 ScoreRole Functioning-1.52 Score on a scaleStandard Deviation 22.95
Nivolumab + IpilimumabChange From Baseline in European Organization for Research and Treatment of Cancer (EORTC) Overall Quality of Life (QOL) C30 ScoreConstipation-3.03 Score on a scaleStandard Deviation 20.339
Nivolumab + IpilimumabChange From Baseline in European Organization for Research and Treatment of Cancer (EORTC) Overall Quality of Life (QOL) C30 ScoreSocial Functioning2.27 Score on a scaleStandard Deviation 22.593
Nivolumab + IpilimumabChange From Baseline in European Organization for Research and Treatment of Cancer (EORTC) Overall Quality of Life (QOL) C30 ScoreDiarrhea-3.03 Score on a scaleStandard Deviation 14.213
Nivolumab + IpilimumabChange From Baseline in European Organization for Research and Treatment of Cancer (EORTC) Overall Quality of Life (QOL) C30 ScoreGlobal Health Status3.79 Score on a scaleStandard Deviation 11.422
Nivolumab + IpilimumabChange From Baseline in European Organization for Research and Treatment of Cancer (EORTC) Overall Quality of Life (QOL) C30 ScoreFinancial Difficulties-3.03 Score on a scaleStandard Deviation 22.792
Nivolumab + IpilimumabChange From Baseline in European Organization for Research and Treatment of Cancer (EORTC) Overall Quality of Life (QOL) C30 ScorePhysical Functioning2.12 Score on a scaleStandard Deviation 17.625
IpilimumabChange From Baseline in European Organization for Research and Treatment of Cancer (EORTC) Overall Quality of Life (QOL) C30 ScoreFinancial Difficulties-2.78 Score on a scaleStandard Deviation 22.285
IpilimumabChange From Baseline in European Organization for Research and Treatment of Cancer (EORTC) Overall Quality of Life (QOL) C30 ScoreFatigue-0.85 Score on a scaleStandard Deviation 17.836
IpilimumabChange From Baseline in European Organization for Research and Treatment of Cancer (EORTC) Overall Quality of Life (QOL) C30 ScoreDyspnea-7.69 Score on a scaleStandard Deviation 27.735
IpilimumabChange From Baseline in European Organization for Research and Treatment of Cancer (EORTC) Overall Quality of Life (QOL) C30 ScorePhysical Functioning1.03 Score on a scaleStandard Deviation 9.367
IpilimumabChange From Baseline in European Organization for Research and Treatment of Cancer (EORTC) Overall Quality of Life (QOL) C30 ScoreRole Functioning5.13 Score on a scaleStandard Deviation 21.926
IpilimumabChange From Baseline in European Organization for Research and Treatment of Cancer (EORTC) Overall Quality of Life (QOL) C30 ScoreEmotional Functioning10.26 Score on a scaleStandard Deviation 17.063
IpilimumabChange From Baseline in European Organization for Research and Treatment of Cancer (EORTC) Overall Quality of Life (QOL) C30 ScoreCognitive Functioning-2.56 Score on a scaleStandard Deviation 11.479
IpilimumabChange From Baseline in European Organization for Research and Treatment of Cancer (EORTC) Overall Quality of Life (QOL) C30 ScoreGlobal Health Status-0.64 Score on a scaleStandard Deviation 29.357
IpilimumabChange From Baseline in European Organization for Research and Treatment of Cancer (EORTC) Overall Quality of Life (QOL) C30 ScoreNausea and Vomiting-2.56 Score on a scaleStandard Deviation 6.259
IpilimumabChange From Baseline in European Organization for Research and Treatment of Cancer (EORTC) Overall Quality of Life (QOL) C30 ScorePain-8.97 Score on a scaleStandard Deviation 21.099
IpilimumabChange From Baseline in European Organization for Research and Treatment of Cancer (EORTC) Overall Quality of Life (QOL) C30 ScoreInsomnia-12.82 Score on a scaleStandard Deviation 16.879
IpilimumabChange From Baseline in European Organization for Research and Treatment of Cancer (EORTC) Overall Quality of Life (QOL) C30 ScoreAppetite Loss-2.56 Score on a scaleStandard Deviation 16.452
IpilimumabChange From Baseline in European Organization for Research and Treatment of Cancer (EORTC) Overall Quality of Life (QOL) C30 ScoreConstipation0.00 Score on a scaleStandard Deviation 13.608
IpilimumabChange From Baseline in European Organization for Research and Treatment of Cancer (EORTC) Overall Quality of Life (QOL) C30 ScoreDiarrhea5.13 Score on a scaleStandard Deviation 12.518
IpilimumabChange From Baseline in European Organization for Research and Treatment of Cancer (EORTC) Overall Quality of Life (QOL) C30 ScoreSocial Functioning0.00 Score on a scaleStandard Deviation 16.667
Secondary

Objective Response Rate (ORR) - BRAF Mutant Participants

Objective Response Rate is defined as the percentage of participants with a best overall response of Complete Response (CR) or Partial Response (PR), assessed by the investigator by using RECIST 1.1 criteria. CR=all target and nontarget lesions have disappeared. Lymph nodes selected must have returned to normal size (\<10 mm). PR=at least a 30% decrease in the sum of the longest diameter (LD) of target lesions, taking as reference the baseline sum LD.

Time frame: From 12 weeks after Randomization, assessed every 6 weeks up to Week 49 of study treatment and then every 12 weeks until disease progression (up to approximately 76 months)

Population: All randomized BRAF mutant participants

ArmMeasureValue (NUMBER)
Nivolumab + IpilimumabObjective Response Rate (ORR) - BRAF Mutant Participants54.5 Percentage of participants
IpilimumabObjective Response Rate (ORR) - BRAF Mutant Participants10.0 Percentage of participants
95% CI: [8.2, 64.8]Fisher Exact
95% CI: [1.07, 511.89]Fisher Exact
Secondary

Progression-Free Survival (PFS) - BRAF Mutant Participants

PFS is defined as the time between the date of randomization and the first date of documented progression, as assessed by the investigator, or death due to any cause, whichever occurs first. Participants who died without a reported progression were considered to have progressed on the date of their death. Participants who did not progress or died were censored on the date of their last evaluable tumor assessment. PFS values are based on Kaplan-Meier Estimates.

Time frame: From randomization to progression or death (up to approximately 88 months)

Population: All randomized BRAF mutant participants

ArmMeasureValue (MEDIAN)
Nivolumab + IpilimumabProgression-Free Survival (PFS) - BRAF Mutant Participants8.61 Months
IpilimumabProgression-Free Survival (PFS) - BRAF Mutant Participants2.73 Months
95% CI: [0.14, 0.97]Unstratified Cox proportional hazard
Secondary

Progression-Free Survival (PFS) - BRAF Wild-type (WT) Participants

PFS is defined as the time between the date of randomization and the first date of documented progression, as assessed by the investigator, or death due to any cause, whichever occurs first. Participants who died without a reported progression were considered to have progressed on the date of their death. Participants who did not progress or died were censored on the date of their last evaluable tumor assessment. PFS values are based on Kaplan-Meier Estimates.

Time frame: From randomization to progression or death (up to approximately 88 months)

Population: All randomized BRAF wild-type participants

ArmMeasureValue (MEDIAN)
Nivolumab + IpilimumabProgression-Free Survival (PFS) - BRAF Wild-type (WT) Participants58.41 Months
IpilimumabProgression-Free Survival (PFS) - BRAF Wild-type (WT) Participants4.30 Months
95% CI: [0.21, 0.59]Unstratified Cox proportional hazard

Source: ClinicalTrials.gov · Data processed: Mar 12, 2026