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Effectiveness Study of Nivolumab Compared to Chemotherapy in Patients With Relapsed Small-cell Lung Cancer

An Open-label, Randomized, Phase 3 Study of Nivolumab or Chemotherapy in Subjects With Relapsed Small-cell Lung Cancer After Platinum-based First Line Chemotherapy (CheckMate 331: CHECKpoint Pathway and nivoluMAb Clinical Trial Evaluation 331)

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT02481830
Acronym
CheckMate331
Enrollment
569
Registered
2015-06-25
Start date
2015-09-14
Completion date
2022-08-30
Last updated
2023-07-27

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

Conditions

Lung Cancer

Brief summary

The purpose of this study is to compare the overall survival of nivolumab versus chemotherapy in subjects with relapsed SCLC.

Interventions

DRUGNivolumab
DRUGTopotecan

Sponsors

Ono Pharmaceutical Co. Ltd
CollaboratorINDUSTRY
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

* Histologically or cytologically confirmed small cell lung cancer (SCLC) * Subjects with either limited or extensive disease stage at the initial diagnosis * Must have recurrence or progression after platinum-based first-line chemotherapy or chemoradiation therapy for the treatment of limited or extensive disease stage SCLC * Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1

Exclusion criteria

* Untreated or symptomatic central nervous system (CNS) metastases * Prior therapy with anti-PD-1, anti-PDL1, anti-PD-L2, anti-CD137, or anti-CTLA-4 antibody * Inadequate hematologic or hepatic function

Design outcomes

Primary

MeasureTime frameDescription
Overall Survival (OS)OS was followed continuously while participants were on the study drug and every 3 months, minimum follow up for overall survival was 15.8 monthsThe time from randomization to the date of death, data was based on Kaplan-Meier Estimates. A participant who has not died will be censored at last known date alive.

Secondary

MeasureTime frameDescription
Progression Free Survival (PFS)From randomization to the date of first documented tumor progression, or death due to any cause. Tumor response assessed every 6 weeks from first dose until week 30, and every 12 weeks (Up to approximately 80 months)PFS is defined as the time from randomization to the date of the first documented tumor progression based on investigator assessment (per RECIST 1.1), or death due to any cause. Participants who die without a reported prior progression will be considered to have progressed on the date of their death. Participants who did not progress or die will be censored on the date of their last evaluable tumor assessment. Participants who did not have any on study tumor assessments and did not die will be censored on the date they were randomized. Participants who started any subsequent anti-cancer therapy without a prior reported progression will be censored at the last evaluable tumor assessment prior to initiation of the subsequent anti-cancer therapy. Progressive disease (PD)= At least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study. The sum must demonstrate an absolute increase of at least 5 mm.
Objective Response Rate (ORR)From randomization to the date of objectively documented progression or the date of subsequent anti-cancer therapy, whichever occurs first (Up to approximately 80 months)ORR is defined as the percentage of randomized participants whose best overall response (BOR) from baseline is either a complete response (CR) or partial response (PR) based on investigator assessment per RECIST 1.1 criteria. For participants without documented progression or subsequent anti-cancer therapy, all available response designations will contribute to the BOR determination. For participants who continue nivolumab beyond progression, the BOR should be determined based on tumor assessments before initial RECIST 1.1 defined progression. CR= Disappearance of all target lesions. Any pathological lymph nodes 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. Progressive disease (PD)= At least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study. The sum must demonstrate an absolute increase of at least 5 mm.

Countries

Australia, Austria, Belgium, Brazil, Chile, China, Czechia, Denmark, France, Germany, Greece, Hungary, Israel, Italy, Japan, Norway, Poland, Romania, Russia, South Korea, Spain, Switzerland, Taiwan, United Kingdom, United States

Participant flow

Participants by arm

ArmCount
Group A
Nivolumab 240mg IV on Day 1 of a 14-day cycle
284
Group B
Chemotherapy (Topotecan 1.5 mg/m\^2 IV or 2.3 mg/m\^2 oral once daily on Days 1 to 5 of a 21-day cycle / Amrubicin 40 mg/m\^2 IV once daily on Days 1 to 3 of a 21-day cycle)
285
Total569

Withdrawals & dropouts

PeriodReasonFG000FG001
Pre-treatmentDisease Progression11
Pre-treatmentOther reasons01
Pre-treatmentParticipant no longer meets Study Criteria14
Pre-treatmentParticipant request to discontinue study treatment04
Pre-treatmentWithdrawal by Subject010
TreatmentAdministrative reason by sponsor11
TreatmentAdverse Event unrelated to Study drug1411
TreatmentDeath11
TreatmentDisease Progression233171
TreatmentLost to Follow-up10
TreatmentMaximum Clinical Benefit05
TreatmentOther reasons61
TreatmentParticipants request to discontinue Study treatment634
TreatmentStudy drug toxicity1838
TreatmentWithdrawal by Subject23

Baseline characteristics

CharacteristicGroup BTotalGroup A
Age, Continuous61.6 Years
STANDARD_DEVIATION 8.4
61.6 Years
STANDARD_DEVIATION 8.8
61.5 Years
STANDARD_DEVIATION 9.2
Ethnicity (NIH/OMB)
Hispanic or Latino
6 Participants10 Participants4 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
142 Participants267 Participants125 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
137 Participants292 Participants155 Participants
Race (NIH/OMB)
American Indian or Alaska Native
1 Participants1 Participants0 Participants
Race (NIH/OMB)
Asian
71 Participants141 Participants70 Participants
Race (NIH/OMB)
Black or African American
2 Participants3 Participants1 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
0 Participants2 Participants2 Participants
Race (NIH/OMB)
White
211 Participants422 Participants211 Participants
Sex: Female, Male
Female
108 Participants218 Participants110 Participants
Sex: Female, Male
Male
177 Participants351 Participants174 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
251 / 284256 / 285
other
Total, other adverse events
249 / 282248 / 265
serious
Total, serious adverse events
183 / 282171 / 265

Outcome results

Primary

Overall Survival (OS)

The time from randomization to the date of death, data was based on Kaplan-Meier Estimates. A participant who has not died will be censored at last known date alive.

Time frame: OS was followed continuously while participants were on the study drug and every 3 months, minimum follow up for overall survival was 15.8 months

Population: All Randomized Participants

ArmMeasureValue (MEDIAN)
Group AOverall Survival (OS)7.46 Months
Group BOverall Survival (OS)8.38 Months
p-value: 0.114495% CI: [0.72, 1.04]Log Rank
Secondary

Objective Response Rate (ORR)

ORR is defined as the percentage of randomized participants whose best overall response (BOR) from baseline is either a complete response (CR) or partial response (PR) based on investigator assessment per RECIST 1.1 criteria. For participants without documented progression or subsequent anti-cancer therapy, all available response designations will contribute to the BOR determination. For participants who continue nivolumab beyond progression, the BOR should be determined based on tumor assessments before initial RECIST 1.1 defined progression. CR= Disappearance of all target lesions. Any pathological lymph nodes 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. Progressive disease (PD)= At least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study. The sum must demonstrate an absolute increase of at least 5 mm.

Time frame: From randomization to the date of objectively documented progression or the date of subsequent anti-cancer therapy, whichever occurs first (Up to approximately 80 months)

Population: All Randomized Participants

ArmMeasureValue (NUMBER)
Group AObjective Response Rate (ORR)13.7 Percentage of Participants
Group BObjective Response Rate (ORR)16.8 Percentage of Participants
95% CI: [0.49, 1.24]
Secondary

Progression Free Survival (PFS)

PFS is defined as the time from randomization to the date of the first documented tumor progression based on investigator assessment (per RECIST 1.1), or death due to any cause. Participants who die without a reported prior progression will be considered to have progressed on the date of their death. Participants who did not progress or die will be censored on the date of their last evaluable tumor assessment. Participants who did not have any on study tumor assessments and did not die will be censored on the date they were randomized. Participants who started any subsequent anti-cancer therapy without a prior reported progression will be censored at the last evaluable tumor assessment prior to initiation of the subsequent anti-cancer therapy. Progressive disease (PD)= At least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study. The sum must demonstrate an absolute increase of at least 5 mm.

Time frame: From randomization to the date of first documented tumor progression, or death due to any cause. Tumor response assessed every 6 weeks from first dose until week 30, and every 12 weeks (Up to approximately 80 months)

Population: All Randomized Participants

ArmMeasureValue (MEDIAN)
Group AProgression Free Survival (PFS)1.45 Months
Group BProgression Free Survival (PFS)3.71 Months
95% CI: [1.16, 1.66]
Post Hoc

Overall Survival (OS) - Extended Collection

The time from randomization to the date of death, data was based on Kaplan-Meier Estimates. A participant who has not died will be censored at last known date alive.

Time frame: OS was followed continuously while participants were on the study drug and every 3 months, minimum follow up for overall survival was 64 months (Up to approximately 80 months)

Population: All Randomized Participants

ArmMeasureValue (MEDIAN)
Group AOverall Survival (OS) - Extended Collection7.46 Months
Group BOverall Survival (OS) - Extended Collection8.38 Months
95% CI: [0.73, 1.04]

Source: ClinicalTrials.gov · Data processed: Mar 1, 2026