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Efficacy Study of Nivolumab Compared to Docetaxel in Subjects Previously Treated With Advanced or Metastatic Non Small Cell Lung Cancer

An Open-label Randomized Multinational Phase 3 Trial of Nivolumab Versus Docetaxel in Previously Treated Subjects With Advanced or Metastatic Non-small Cell Lung Cancer (CheckMate 078: CHECKpoint Pathway and nivoluMAb Clinical Trial Evaluation 078)

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT02613507
Acronym
CheckMate 078
Enrollment
504
Registered
2015-11-24
Start date
2015-12-11
Completion date
2023-11-24
Last updated
2024-11-19

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

Conditions

Non-Small Cell Lung Cancer

Brief summary

The purpose of this study is to determine whether Nivolumab improves life expectancy compared to Docetaxel in Subjects with Advanced or Metastatic Non-small Cell Lung Cancer who have failed prior platinum-based doublet chemotherapy.

Interventions

DRUGNivolumab
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

For more information regarding BMS clinical trial participation, please visit www.BMSStudyConnect.com Inclusion Criteria: * Disease progression experienced during or after one prior platinum containing doublet chemotherapy * Stage IIIb/IV or recurrent disease * Male and Female ≥ 18 years of age * Measurable disease per RECIST 1.1 * Performance Status ≤ 1

Exclusion criteria

* History of Carcinomatous meningitis * Active Central nervous system (CNS) metastases * History of auto immune diseases * Prior treatment with Docetaxel * Prior treatment with ipilimumab or any drug targeting T-Cell costimulation or checkpoint pathways

Design outcomes

Primary

MeasureTime frameDescription
Median Overall SurvivalFrom randomization to the date of death or date participant was last known to be alive (assessed from December 2015 to Oct 2017 approximately 22 months)OS was defined as the time between the date of randomization and the date of death. For subjects without documentation of death, OS was censored on the last date the subject was known to be alive
Overall Survival RateFrom first dose to the date of death or date participant was last known to be alive (assessed from December 2015 to Oct 2017 approximately 22 months)OS was defined as the time between the date of randomization and the date of death. For subjects without documentation of death, OS was censored on the last date the subject was known to be alive. Rates provided are Kaplan-Meier estimates.

Secondary

MeasureTime frameDescription
Progression Free Survival (PFS)From the time of randomization to the date of the first documented tumor progression or death due to any cause (up to approximately 90 months)PFS was defined as the time from randomization to the date of the first documented tumor progression as determined by investigators per RECIST 1.1, or death due to any cause. Clinical deterioration in the absence of unequivocal evidence of progression was not considered progression for purposes of determining PFS. Participants who died without a reported prior progression were considered to have progressed on the date of their death. Participants who did not have disease progression or die were censored on the date of their last evaluable tumor assessment. Participants who did not have any on study tumor assessments and did not die were censored at the randomization date. Participants who started any subsequent anti-cancer therapy (including on-treatment palliative RT of non-target bone lesions, skin lesions or CNS lesions) without a prior reported progression were censored at the last evaluable tumor assessment prior to or on initiation of the subsequent anti-cancer therapy.
Progression Free Survival RateFrom the time of randomization up to 6 monthsClinical deterioration in the absence of unequivocal evidence of progression (per RECIST 1.1) is not considered progression for purposes of determining PFS. Participants who die without a reported prior progression will be considered to have progressed on the date of their death. Participants who did not have disease progression 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 at the randomization date. Participants who started any subsequent anti-cancer therapy without a prior reported progression will be censored at the last evaluable tumor assessment prior to or on initiation of the subsequent anti-cancer therapy. Six month progression-free survival rate as estimated using the Kaplan-Meier method
Time to Treatment Failure (TTF)From randomization up to disease progression, death, or last dose (up to approximately 17 months)TTF was defined as the minimum of the time from randomization to disease progression (per RECIST 1.1 or clinical), death or last dose date if a participant discontinued from treatment for any reasons other than maximum clinical benefit and administrative reasons by sponsor. TTF was considered as event at the randomization date for participants who were randomized but not treated. TTF was censored at the last dose date for participants who discontinued treatment due to maximum clinical benefit or administrative reasons by sponsor. TTF was censored at the last dose date for participants who continued on treatment without progression or death. This outcome measure was prespecified in the protocol to only be evaluated through the first Interim Analysis, which occurred in June 2017.
Objective Response Rate (ORR)From date of first dose up to partial or complete response (up to approximately 90 months)Investigator assessed ORR was defined as the number of participants whose best objective response (BOR) was a confirmed complete response (CR) or confirmed partial response (PR), as determined by the investigator, divided by the number of randomized participants. 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.
Number of Participants Experiencing Treatment-Related Serious Adverse Events (SAEs)From first dose up to 100 days after last dose (up to 93 months)A treatment-related Serious Adverse Event (SAE) is defined as any untoward medical occurrence that, at any dose results in death, is life-threatening (defined as an event in which the participant was at risk of death at the time of the event; it does not refer to an event which hypothetically might have caused death if it were more severe), requires inpatient hospitalization or causes prolongation of existing hospitalization and is determined to be associated with the study treatment.
Disease Related Symptom Deterioration Rate by Week 12 and Week 24At Week 12 and Week 24Disease-Related Symptom Deterioration Rate is the percentage of participants with \>=10 points increase from baseline in Average Symptom Burden Index (ASBI) score at any time between randomization and the timepoints. The Lung Cancer Symptom Scale (LCSS) measures 6 items (loss of appetite, fatigue, coughing, shortness of breath, hemoptysis, pain) and 3 symptom burden items (disease-related functional limitations, quality of life) with responses captured using a 100mm visual analog scale (VAS). Scores range from 0 (highest quality of life) to 100 (worst quality of life) and is derived by dividing the length of the line drawn from the lowest possible response to the patient's response by the length of the VAS and multiplying the result by 100. An ASBI score can be derived as the mean of scores for the 6 symptom-related items with a clinically meaningful change in ASBI score being 10 points and a meaningful deterioration in symptoms is a mean post-baseline score change \>= 10 points.
Number of Participants Experiencing Treatment-Related Adverse Events (AEs)From first dose up to 100 days after last dose (up to 93 months)A treatment-related Adverse Event (AE) is defined as any new untoward medical occurrence or worsening of a pre-existing medical condition in a clinical investigation participant administered study treatment and is determined to be associated with the study treatment. Adverse events are graded on a scale from 1 to 5, with Grade 1 being mild and asymptomatic; Grade 2 is moderate requiring minimal, local or noninvasive intervention; Grade 3 is severe or medically significant but not immediately life-threatening; Grade 4 events are usually severe enough to require hospitalization; Grade 5 events are fatal.
Overall Survival (OS) in SubpopulationsFrom randomization to the date of death or date participant was last known to be alive (up to approximately 90 months)OS was defined as the time between the date of randomization and the date of death. For participants without documentation of death, OS was censored on the last date the participant was known to be alive. Test stratified by histology (SQ vs NSQ), PD-L1 status at 1% expression level (positive vs negative/unevaluable).

Countries

China, Hong Kong, Russia, Singapore

Participant flow

Participants by arm

ArmCount
Nivolumab
3 mg/kg every 2 weeks until disease progression or unacceptable toxicity
338
Docetaxel
75 mg/m² every 3 weeks until disease progression or unacceptable toxicity
166
Total504

Withdrawals & dropouts

PeriodReasonFG000FG001
Pre-TreamtentParticipant no longer meets study criteria11
Pre-TreamtentParticipant request to discontinue study treatment05
Pre-TreamtentParticipant withdrew consent04
TreatmentAdverse event unrelated to study drug203
TreatmentDeath20
TreatmentDisease progression263110
TreatmentLost to Follow-up10
TreatmentMaximum clinical benefit510
TreatmentNot reported30
TreatmentOther reasons80
TreatmentParticipant no longer meets criteria30
TreatmentParticipant request to discontinue study treatment1317
TreatmentParticipant withdrew consent02
TreatmentStudy drug toxicity1914

Baseline characteristics

CharacteristicNivolumabDocetaxelTotal
Age, Continuous59.1 Years
STANDARD_DEVIATION 9.07
59.3 Years
STANDARD_DEVIATION 8.13
59.1 Years
STANDARD_DEVIATION 8.77
Race/Ethnicity, Customized
Asian Other
2 Participants0 Participants2 Participants
Race/Ethnicity, Customized
Chinese
306 Participants151 Participants457 Participants
Race/Ethnicity, Customized
White
30 Participants15 Participants45 Participants
Sex/Gender, Customized
Female
75 Participants32 Participants107 Participants
Sex/Gender, Customized
Male
263 Participants134 Participants397 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
deaths
Total, all-cause mortality
294 / 337146 / 1568 / 9
other
Total, other adverse events
318 / 337146 / 1569 / 9
serious
Total, serious adverse events
183 / 33773 / 1564 / 9

Outcome results

Primary

Median Overall Survival

OS was defined as the time between the date of randomization and the date of death. For subjects without documentation of death, OS was censored on the last date the subject was known to be alive

Time frame: From randomization to the date of death or date participant was last known to be alive (assessed from December 2015 to Oct 2017 approximately 22 months)

Population: All randomized participants

ArmMeasureValue (MEDIAN)
NivolumabMedian Overall Survival11.99 Months
DocetaxelMedian Overall Survival9.63 Months
p-value: 0.0006Stratified weighted Log-Rank
97.7% CI: [0.52, 0.9]Stratified Cox Proportional Hazard Model
p-value: 0.0017Log Rank
Primary

Overall Survival Rate

OS was defined as the time between the date of randomization and the date of death. For subjects without documentation of death, OS was censored on the last date the subject was known to be alive. Rates provided are Kaplan-Meier estimates.

Time frame: From first dose to the date of death or date participant was last known to be alive (assessed from December 2015 to Oct 2017 approximately 22 months)

Population: All randomized participants

ArmMeasureGroupValue (NUMBER)
NivolumabOverall Survival RateRate at 6 months72.4 percentage
NivolumabOverall Survival RateRate at 12 months49.7 percentage
DocetaxelOverall Survival RateRate at 6 months64.8 percentage
DocetaxelOverall Survival RateRate at 12 months38.8 percentage
Secondary

Disease Related Symptom Deterioration Rate by Week 12 and Week 24

Disease-Related Symptom Deterioration Rate is the percentage of participants with \>=10 points increase from baseline in Average Symptom Burden Index (ASBI) score at any time between randomization and the timepoints. The Lung Cancer Symptom Scale (LCSS) measures 6 items (loss of appetite, fatigue, coughing, shortness of breath, hemoptysis, pain) and 3 symptom burden items (disease-related functional limitations, quality of life) with responses captured using a 100mm visual analog scale (VAS). Scores range from 0 (highest quality of life) to 100 (worst quality of life) and is derived by dividing the length of the line drawn from the lowest possible response to the patient's response by the length of the VAS and multiplying the result by 100. An ASBI score can be derived as the mean of scores for the 6 symptom-related items with a clinically meaningful change in ASBI score being 10 points and a meaningful deterioration in symptoms is a mean post-baseline score change \>= 10 points.

Time frame: At Week 12 and Week 24

Population: All randomized participants

ArmMeasureGroupValue (NUMBER)
NivolumabDisease Related Symptom Deterioration Rate by Week 12 and Week 24Week 1229.9 Percentage of participants
NivolumabDisease Related Symptom Deterioration Rate by Week 12 and Week 24Week 2434.6 Percentage of participants
DocetaxelDisease Related Symptom Deterioration Rate by Week 12 and Week 24Week 1240.4 Percentage of participants
DocetaxelDisease Related Symptom Deterioration Rate by Week 12 and Week 24Week 2442.2 Percentage of participants
Secondary

Number of Participants Experiencing Treatment-Related Adverse Events (AEs)

A treatment-related Adverse Event (AE) is defined as any new untoward medical occurrence or worsening of a pre-existing medical condition in a clinical investigation participant administered study treatment and is determined to be associated with the study treatment. Adverse events are graded on a scale from 1 to 5, with Grade 1 being mild and asymptomatic; Grade 2 is moderate requiring minimal, local or noninvasive intervention; Grade 3 is severe or medically significant but not immediately life-threatening; Grade 4 events are usually severe enough to require hospitalization; Grade 5 events are fatal.

Time frame: From first dose up to 100 days after last dose (up to 93 months)

Population: All treated participants

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
NivolumabNumber of Participants Experiencing Treatment-Related Adverse Events (AEs)220 Participants
DocetaxelNumber of Participants Experiencing Treatment-Related Adverse Events (AEs)131 Participants
Secondary

Number of Participants Experiencing Treatment-Related Serious Adverse Events (SAEs)

A treatment-related Serious Adverse Event (SAE) is defined as any untoward medical occurrence that, at any dose results in death, is life-threatening (defined as an event in which the participant was at risk of death at the time of the event; it does not refer to an event which hypothetically might have caused death if it were more severe), requires inpatient hospitalization or causes prolongation of existing hospitalization and is determined to be associated with the study treatment.

Time frame: From first dose up to 100 days after last dose (up to 93 months)

Population: All treated participants

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
NivolumabNumber of Participants Experiencing Treatment-Related Serious Adverse Events (SAEs)34 Participants
DocetaxelNumber of Participants Experiencing Treatment-Related Serious Adverse Events (SAEs)25 Participants
Secondary

Objective Response Rate (ORR)

Investigator assessed ORR was defined as the number of participants whose best objective response (BOR) was a confirmed complete response (CR) or confirmed partial response (PR), as determined by the investigator, divided by the number of randomized participants. 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 date of first dose up to partial or complete response (up to approximately 90 months)

Population: All randomized participants

ArmMeasureGroupValue (NUMBER)
NivolumabObjective Response Rate (ORR)All randomized participants17.5 Percentage of participants
NivolumabObjective Response Rate (ORR)Squamous NSCLC21.1 Percentage of participants
NivolumabObjective Response Rate (ORR)Non-Squamous NSCLC15.1 Percentage of participants
NivolumabObjective Response Rate (ORR)PD-L1 >= 1%17.3 Percentage of participants
NivolumabObjective Response Rate (ORR)PD-L1 < 1%18.1 Percentage of participants
NivolumabObjective Response Rate (ORR)PD-L1 Non-quantifiable15.6 Percentage of participants
NivolumabObjective Response Rate (ORR)Chinese17.2 Percentage of participants
NivolumabObjective Response Rate (ORR)Non-Chinese19.4 Percentage of participants
DocetaxelObjective Response Rate (ORR)Non-Chinese11.8 Percentage of participants
DocetaxelObjective Response Rate (ORR)All randomized participants4.2 Percentage of participants
DocetaxelObjective Response Rate (ORR)PD-L1 < 1%3.0 Percentage of participants
DocetaxelObjective Response Rate (ORR)Squamous NSCLC1.5 Percentage of participants
DocetaxelObjective Response Rate (ORR)Chinese3.4 Percentage of participants
DocetaxelObjective Response Rate (ORR)Non-Squamous NSCLC6.1 Percentage of participants
DocetaxelObjective Response Rate (ORR)PD-L1 Non-quantifiableNA Percentage of participants
DocetaxelObjective Response Rate (ORR)PD-L1 >= 1%6.0 Percentage of participants
Secondary

Overall Survival (OS) in Subpopulations

OS was defined as the time between the date of randomization and the date of death. For participants without documentation of death, OS was censored on the last date the participant was known to be alive. Test stratified by histology (SQ vs NSQ), PD-L1 status at 1% expression level (positive vs negative/unevaluable).

Time frame: From randomization to the date of death or date participant was last known to be alive (up to approximately 90 months)

Population: All randomized participants

ArmMeasureGroupValue (MEDIAN)
NivolumabOverall Survival (OS) in SubpopulationsLess than 1% PD-L1 expression11.37 Months
NivolumabOverall Survival (OS) in SubpopulationsHistologically Squamous11.70 Months
NivolumabOverall Survival (OS) in SubpopulationsGreater than/equal to 1% PD-L1 expression11.99 Months
NivolumabOverall Survival (OS) in SubpopulationsHistologically Non-squamous11.86 Months
NivolumabOverall Survival (OS) in SubpopulationsNon-quantifiable PD-L1 Expression15.57 Months
NivolumabOverall Survival (OS) in SubpopulationsChinese participants11.76 Months
NivolumabOverall Survival (OS) in SubpopulationsNon-Chinese participants12.98 Months
DocetaxelOverall Survival (OS) in SubpopulationsChinese participants8.57 Months
DocetaxelOverall Survival (OS) in SubpopulationsNon-Chinese participants16.30 Months
DocetaxelOverall Survival (OS) in SubpopulationsGreater than/equal to 1% PD-L1 expression7.89 Months
DocetaxelOverall Survival (OS) in SubpopulationsLess than 1% PD-L1 expression10.25 Months
DocetaxelOverall Survival (OS) in SubpopulationsNon-quantifiable PD-L1 Expression16.30 Months
DocetaxelOverall Survival (OS) in SubpopulationsHistologically Squamous7.89 Months
DocetaxelOverall Survival (OS) in SubpopulationsHistologically Non-squamous10.22 Months
Secondary

Progression Free Survival (PFS)

PFS was defined as the time from randomization to the date of the first documented tumor progression as determined by investigators per RECIST 1.1, or death due to any cause. Clinical deterioration in the absence of unequivocal evidence of progression was not considered progression for purposes of determining PFS. Participants who died without a reported prior progression were considered to have progressed on the date of their death. Participants who did not have disease progression or die were censored on the date of their last evaluable tumor assessment. Participants who did not have any on study tumor assessments and did not die were censored at the randomization date. Participants who started any subsequent anti-cancer therapy (including on-treatment palliative RT of non-target bone lesions, skin lesions or CNS lesions) without a prior reported progression were censored at the last evaluable tumor assessment prior to or on initiation of the subsequent anti-cancer therapy.

Time frame: From the time of randomization to the date of the first documented tumor progression or death due to any cause (up to approximately 90 months)

Population: All randomized participants

ArmMeasureGroupValue (MEDIAN)
NivolumabProgression Free Survival (PFS)All randomized participants2.79 Months
NivolumabProgression Free Survival (PFS)Histologically Squamous2.92 Months
NivolumabProgression Free Survival (PFS)Histologically Non-Squamous2.60 Months
NivolumabProgression Free Survival (PFS)PD-L1 >= 1%2.76 Months
NivolumabProgression Free Survival (PFS)PD-L1 < 1%2.86 Months
NivolumabProgression Free Survival (PFS)PD-L1 Non-quantifiable2.00 Months
NivolumabProgression Free Survival (PFS)Chinese participants2.76 Months
NivolumabProgression Free Survival (PFS)Non-Chinese participants3.50 Months
DocetaxelProgression Free Survival (PFS)PD-L1 >= 1%2.56 Months
DocetaxelProgression Free Survival (PFS)All randomized participants2.76 Months
DocetaxelProgression Free Survival (PFS)PD-L1 Non-quantifiable4.07 Months
DocetaxelProgression Free Survival (PFS)Histologically Squamous2.66 Months
DocetaxelProgression Free Survival (PFS)Non-Chinese participants8.48 Months
DocetaxelProgression Free Survival (PFS)PD-L1 < 1%2.78 Months
DocetaxelProgression Free Survival (PFS)Histologically Non-Squamous2.83 Months
DocetaxelProgression Free Survival (PFS)Chinese participants2.69 Months
Secondary

Progression Free Survival Rate

Clinical deterioration in the absence of unequivocal evidence of progression (per RECIST 1.1) is not considered progression for purposes of determining PFS. Participants who die without a reported prior progression will be considered to have progressed on the date of their death. Participants who did not have disease progression 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 at the randomization date. Participants who started any subsequent anti-cancer therapy without a prior reported progression will be censored at the last evaluable tumor assessment prior to or on initiation of the subsequent anti-cancer therapy. Six month progression-free survival rate as estimated using the Kaplan-Meier method

Time frame: From the time of randomization up to 6 months

Population: All randomized participants

ArmMeasureValue (NUMBER)
NivolumabProgression Free Survival Rate29.3 Percentage
DocetaxelProgression Free Survival Rate24.8 Percentage
Secondary

Time to Treatment Failure (TTF)

TTF was defined as the minimum of the time from randomization to disease progression (per RECIST 1.1 or clinical), death or last dose date if a participant discontinued from treatment for any reasons other than maximum clinical benefit and administrative reasons by sponsor. TTF was considered as event at the randomization date for participants who were randomized but not treated. TTF was censored at the last dose date for participants who discontinued treatment due to maximum clinical benefit or administrative reasons by sponsor. TTF was censored at the last dose date for participants who continued on treatment without progression or death. This outcome measure was prespecified in the protocol to only be evaluated through the first Interim Analysis, which occurred in June 2017.

Time frame: From randomization up to disease progression, death, or last dose (up to approximately 17 months)

Population: All randomized participants with at least 8 months of follow-up at the time of TTF analysis. The clinical database cutoff date will occur when the first approximately 380 randomized participants will have at least 8-month of follow-up.

ArmMeasureValue (MEDIAN)
NivolumabTime to Treatment Failure (TTF)2.60 Months
DocetaxelTime to Treatment Failure (TTF)1.51 Months

Source: ClinicalTrials.gov · Data processed: Mar 5, 2026