Various Advanced Cancer
Conditions
Brief summary
The main purpose of this study is to compare how long subjects with esophageal cancer live overall or live without disease progression after receiving nivolumab and ipilimumab or nivolumab combined with fluorouracil plus cisplatin versus fluorouracil plus cisplatin
Interventions
Specified dose on specified days
Specified dose on specified days
Specified dose on specified days
Specified dose on specified days
Sponsors
Study design
Eligibility
Inclusion criteria
* Must have histologically confirmed squamous cell carcinoma or adenosquamous cell carcinoma of esophagus * Male or Female at least 18 years of age * Must have esophageal cancer that cannot be operated on, or treated with definitive chemoradiation with curative intent, that is advanced, reoccurring or has spread out * Must have full activity or, if limited, must be able to walk and carry out light activities such as light house work or office work * Must agree to provide tumor tissue sample, either from a previous surgery or biopsy within 6 months or fresh, prior to the start of treatment in this study
Exclusion criteria
* Presence of tumor cells in the brain or spinal cord which are symptomatic or require treatment * Active known or suspected autoimmune disease * Any serious or uncontrolled medical disorder or active infection * Known history of positive test for human immunodeficiency virus (HIV) or known acquired immunodeficiency syndrome (AIDS) * Any positive test result for hepatitis B or C indicating acute or chronic infection and/or detectable virus Other protocol defined inclusion/
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Overall Survival (OS) in Participants With Tumor Cell PD-L1 | From the date of randomization to up to the date of death (up to approximately 20 months) | Overall Survival (OS) is defined as the time between the date of randomization and the date of death. For participants without documentation of death, OS will be censored on the last date the subject was known to be alive. |
| Progression-free Survival (PFS) as Assessed by BICR in Participants With Tumor Cell PD-L1 | From the date of randomization to up to the date of the first documented disease progression or death (up to approximately 9 months) | Progression-free survival (PFS) is defined as the time from randomization to the date of the first documented progressive disease (PD) per Blinded Independent Central Review (BICR) or death due to any cause. Participants who die without a reported prior PD per BICR (and die without start of subsequent therapy) will be considered to have progressed on the date of death. Participants who did not have documented PD per BICR per RECIST1.1 criteria and who did not die, will be censored at the date of the last evaluable tumor assessment on or prior to initiation of the subsequent anti-cancer therapy. Participants who did not have any on-study tumor assessments and did not die (or died after initiation of the subsequent anti-cancer therapy) will be censored at the randomization date. Participants who started any subsequent anti-cancer therapy without a prior reported PD per BICR will be censored at the last tumor assessment on or prior to initiation of the subsequent anti-cancer therapy. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Overall Survival (OS) in All Randomized Participants | From the date of randomization to up to the date of death (up to approximately 88 months) | Overall Survival (OS) is defined as the time between the date of randomization and the date of death. For participants without documentation of death, OS will be censored on the last date the subject was known to be alive. |
| Progression-free Survival (PFS) in All Randomized Participants as Assessed by BICR | From the date of randomization to up to the date of the first documented disease progression or death (up to approximately 88 months) | Progression-free survival (PFS) is defined as the time from randomization to the date of the first documented progressive disease (PD) per Blinded Independent Central Review (BICR) or death due to any cause. Participants who die without a reported prior PD per BICR (and die without start of subsequent therapy) will be considered to have progressed on the date of death. Participants who did not have documented PD per BICR per RECIST1.1 criteria and who did not die, will be censored at the date of the last evaluable tumor assessment on or prior to initiation of the subsequent anti-cancer therapy. Participants who did not have any on-study tumor assessments and did not die (or died after initiation of the subsequent anti-cancer therapy) will be censored at the randomization date. Participants who started any subsequent anti-cancer therapy without a prior reported PD per BICR will be censored at the last tumor assessment on or prior to initiation of the subsequent anti-cancer therapy. |
| Objective Response Rate (ORR) as Assessed by BICR | From the date of randomization to up to the date of objectively documented progression or the date of subsequent anti-cancer therapy, whichever occurs first (up to 88 months) | Objective response rate (ORR) is defined as the percentage of participants with a best overall response (BOR) of complete response (CR) or partial response (PR). Best overall response (BOR) is defined as the best response designation as determined by BICR, recorded between the date of randomization and the date of objectively documented progression (per RECIST 1.1) or the date of subsequent anti-cancer therapy (including tumor-directed radiotherapy and tumor-directed surgery), whichever occurs first. Partial response is defined as at least a 30% decrease in the sum of diameters of target lesions. Complete response is defined as the disappearance of all target lesions and the reduction of any pathological lymph nodes to \<10 mm. |
Countries
Argentina, Australia, Austria, Brazil, Canada, Chile, China, Colombia, Czechia, Denmark, France, Hong Kong, Italy, Japan, Mexico, Peru, Poland, Portugal, Romania, Russia, Singapore, South Korea, Spain, Taiwan, Turkey (Türkiye), United Kingdom, United States
Contacts
Bristol-Myers Squibb
Participant flow
Pre-assignment details
970 participants randomized, 936 treated.
Participants by arm
| Arm | Count |
|---|---|
| Arm A: Nivolumab + Ipilimumab Participants will receive treatment with nivolumab 3 mg/kg as a 30-minute infusion every 2 weeks and ipilimumab as a 30-minute infusion 1 mg/kg every 6 weeks. | 325 |
| Arm B: Nivolumab + Chemotherapy Participants will receive treatment with nivolumab 240 mg as a 30-minute infusion on Day 1 and Day 15, fluorouracil 800 mg/m²/day as an IV continuous infusion on Day 1 through Day 5 (for 5 days), and cisplatin 80 mg/m² as a 30- to 120-minute infusion on Day 1 of 4-week cycle. | 321 |
| Arm C: Chemotherapy Participants will receive treatment with fluorouracil 800 mg/m²/day as an IV continuous infusion from Day 1 through Day 5 (for 5 days), and cisplatin 80 mg/m² as a 30- to 120-minute infusion on Day 1 of 4-week cycle. | 324 |
| Total | 970 |
Baseline characteristics
| Characteristic | Arm A: Nivolumab + Ipilimumab | Arm B: Nivolumab + Chemotherapy | Arm C: Chemotherapy | Total |
|---|---|---|---|---|
| Age, Continuous | 62.2 Years STANDARD_DEVIATION 9.1 | 63.1 Years STANDARD_DEVIATION 9.2 | 63.3 Years STANDARD_DEVIATION 8.7 | 62.9 Years STANDARD_DEVIATION 9 |
| Race/Ethnicity, Customized American Indian or Alaska Native | 1 Participants | 2 Participants | 1 Participants | 4 Participants |
| Race/Ethnicity, Customized Asian Indian | 1 Participants | 4 Participants | 3 Participants | 8 Participants |
| Race/Ethnicity, Customized Asian Other | 28 Participants | 23 Participants | 17 Participants | 68 Participants |
| Race/Ethnicity, Customized Black or African American | 4 Participants | 1 Participants | 6 Participants | 11 Participants |
| Race/Ethnicity, Customized Chinese | 71 Participants | 74 Participants | 70 Participants | 215 Participants |
| Race/Ethnicity, Customized Japanese | 131 Participants | 126 Participants | 137 Participants | 394 Participants |
| Race/Ethnicity, Customized Other | 10 Participants | 6 Participants | 6 Participants | 22 Participants |
| Race/Ethnicity, Customized White | 79 Participants | 85 Participants | 84 Participants | 248 Participants |
| Sex: Female, Male Female | 56 Participants | 68 Participants | 49 Participants | 173 Participants |
| Sex: Female, Male Male | 269 Participants | 253 Participants | 275 Participants | 797 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk |
|---|---|---|---|
| deaths Total, all-cause mortality | 270 / 325 | 273 / 321 | 286 / 324 |
| other Total, other adverse events | 301 / 322 | 307 / 310 | 288 / 304 |
| serious Total, serious adverse events | 243 / 322 | 226 / 310 | 174 / 304 |
Outcome results
Overall Survival (OS) in Participants With Tumor Cell PD-L1
Overall Survival (OS) is defined as the time between the date of randomization and the date of death. For participants without documentation of death, OS will be censored on the last date the subject was known to be alive.
Time frame: From the date of randomization to up to the date of death (up to approximately 20 months)
Population: All randomized PD-L1 expressing participants
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Arm A: Nivolumab + Ipilimumab | Overall Survival (OS) in Participants With Tumor Cell PD-L1 | 13.70 Months |
| Arm B: Nivolumab + Chemotherapy | Overall Survival (OS) in Participants With Tumor Cell PD-L1 | 15.44 Months |
| Arm C: Chemotherapy | Overall Survival (OS) in Participants With Tumor Cell PD-L1 | 9.07 Months |
Progression-free Survival (PFS) as Assessed by BICR in Participants With Tumor Cell PD-L1
Progression-free survival (PFS) is defined as the time from randomization to the date of the first documented progressive disease (PD) per Blinded Independent Central Review (BICR) or death due to any cause. Participants who die without a reported prior PD per BICR (and die without start of subsequent therapy) will be considered to have progressed on the date of death. Participants who did not have documented PD per BICR per RECIST1.1 criteria and who did not die, will be censored at the date of the last evaluable tumor assessment on or prior to initiation of the subsequent anti-cancer therapy. Participants who did not have any on-study tumor assessments and did not die (or died after initiation of the subsequent anti-cancer therapy) will be censored at the randomization date. Participants who started any subsequent anti-cancer therapy without a prior reported PD per BICR will be censored at the last tumor assessment on or prior to initiation of the subsequent anti-cancer therapy.
Time frame: From the date of randomization to up to the date of the first documented disease progression or death (up to approximately 9 months)
Population: All randomized PD-L1 expressing participants
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Arm A: Nivolumab + Ipilimumab | Progression-free Survival (PFS) as Assessed by BICR in Participants With Tumor Cell PD-L1 | 4.04 Months |
| Arm B: Nivolumab + Chemotherapy | Progression-free Survival (PFS) as Assessed by BICR in Participants With Tumor Cell PD-L1 | 6.93 Months |
| Arm C: Chemotherapy | Progression-free Survival (PFS) as Assessed by BICR in Participants With Tumor Cell PD-L1 | 4.44 Months |
Objective Response Rate (ORR) as Assessed by BICR
Objective response rate (ORR) is defined as the percentage of participants with a best overall response (BOR) of complete response (CR) or partial response (PR). Best overall response (BOR) is defined as the best response designation as determined by BICR, recorded between the date of randomization and the date of objectively documented progression (per RECIST 1.1) or the date of subsequent anti-cancer therapy (including tumor-directed radiotherapy and tumor-directed surgery), whichever occurs first. Partial response is defined as at least a 30% decrease in the sum of diameters of target lesions. Complete response is defined as the disappearance of all target lesions and the reduction of any pathological lymph nodes to \<10 mm.
Time frame: From the date of randomization to up to the date of objectively documented progression or the date of subsequent anti-cancer therapy, whichever occurs first (up to 40 months)
Population: All randomized PD-L1 expressing participants and all randomized participants
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Arm A: Nivolumab + Ipilimumab | Objective Response Rate (ORR) as Assessed by BICR | Participants with baseline PD-L1 status >= 10% | 36.9 Percentage of participants |
| Arm A: Nivolumab + Ipilimumab | Objective Response Rate (ORR) as Assessed by BICR | Participants with baseline PD-L1 status < 5% | 22.3 Percentage of participants |
| Arm A: Nivolumab + Ipilimumab | Objective Response Rate (ORR) as Assessed by BICR | Participants with baseline PD-L1 status indeterminate, not evaluable, or missing | 33.3 Percentage of participants |
| Arm A: Nivolumab + Ipilimumab | Objective Response Rate (ORR) as Assessed by BICR | All randomized participants | 27.7 Percentage of participants |
| Arm A: Nivolumab + Ipilimumab | Objective Response Rate (ORR) as Assessed by BICR | Participants with baseline PD-L1 status < 1% | 20.1 Percentage of participants |
| Arm A: Nivolumab + Ipilimumab | Objective Response Rate (ORR) as Assessed by BICR | Participants with baseline PD-L1 status >= 1% | 35.4 Percentage of participants |
| Arm A: Nivolumab + Ipilimumab | Objective Response Rate (ORR) as Assessed by BICR | Participants with baseline PD-L1 status >= 5% | 36.7 Percentage of participants |
| Arm A: Nivolumab + Ipilimumab | Objective Response Rate (ORR) as Assessed by BICR | Participants with baseline PD-L1 status < 10% | 23.3 Percentage of participants |
| Arm B: Nivolumab + Chemotherapy | Objective Response Rate (ORR) as Assessed by BICR | Participants with baseline PD-L1 status >= 10% | 50.0 Percentage of participants |
| Arm B: Nivolumab + Chemotherapy | Objective Response Rate (ORR) as Assessed by BICR | Participants with baseline PD-L1 status < 1% | 41.7 Percentage of participants |
| Arm B: Nivolumab + Chemotherapy | Objective Response Rate (ORR) as Assessed by BICR | Participants with baseline PD-L1 status < 10% | 46.1 Percentage of participants |
| Arm B: Nivolumab + Chemotherapy | Objective Response Rate (ORR) as Assessed by BICR | Participants with baseline PD-L1 status < 5% | 44.8 Percentage of participants |
| Arm B: Nivolumab + Chemotherapy | Objective Response Rate (ORR) as Assessed by BICR | Participants with baseline PD-L1 status >= 5% | 51.7 Percentage of participants |
| Arm B: Nivolumab + Chemotherapy | Objective Response Rate (ORR) as Assessed by BICR | All randomized participants | 47.4 Percentage of participants |
| Arm B: Nivolumab + Chemotherapy | Objective Response Rate (ORR) as Assessed by BICR | Participants with baseline PD-L1 status >= 1% | 53.2 Percentage of participants |
| Arm C: Chemotherapy | Objective Response Rate (ORR) as Assessed by BICR | All randomized participants | 26.9 Percentage of participants |
| Arm C: Chemotherapy | Objective Response Rate (ORR) as Assessed by BICR | Participants with baseline PD-L1 status < 1% | 33.7 Percentage of participants |
| Arm C: Chemotherapy | Objective Response Rate (ORR) as Assessed by BICR | Participants with baseline PD-L1 status >= 1% | 19.9 Percentage of participants |
| Arm C: Chemotherapy | Objective Response Rate (ORR) as Assessed by BICR | Participants with baseline PD-L1 status < 5% | 30.9 Percentage of participants |
| Arm C: Chemotherapy | Objective Response Rate (ORR) as Assessed by BICR | Participants with baseline PD-L1 status >= 5% | 20.0 Percentage of participants |
| Arm C: Chemotherapy | Objective Response Rate (ORR) as Assessed by BICR | Participants with baseline PD-L1 status < 10% | 29.3 Percentage of participants |
| Arm C: Chemotherapy | Objective Response Rate (ORR) as Assessed by BICR | Participants with baseline PD-L1 status >= 10% | 21.6 Percentage of participants |
| Arm C: Chemotherapy | Objective Response Rate (ORR) as Assessed by BICR | Participants with baseline PD-L1 status indeterminate, not evaluable, or missing | 0.0 Percentage of participants |
Overall Survival (OS) in All Randomized Participants
Overall Survival (OS) is defined as the time between the date of randomization and the date of death. For participants without documentation of death, OS will be censored on the last date the subject was known to be alive.
Time frame: From the date of randomization to up to the date of death (up to approximately 16 months)
Population: All randomized participants
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Arm A: Nivolumab + Ipilimumab | Overall Survival (OS) in All Randomized Participants | 12.75 Months |
| Arm B: Nivolumab + Chemotherapy | Overall Survival (OS) in All Randomized Participants | 13.21 Months |
| Arm C: Chemotherapy | Overall Survival (OS) in All Randomized Participants | 10.71 Months |
Progression-free Survival (PFS) in All Randomized Participants as Assessed by BICR
Progression-free survival (PFS) is defined as the time from randomization to the date of the first documented progressive disease (PD) per Blinded Independent Central Review (BICR) or death due to any cause. Participants who die without a reported prior PD per BICR (and die without start of subsequent therapy) will be considered to have progressed on the date of death. Participants who did not have documented PD per BICR per RECIST1.1 criteria and who did not die, will be censored at the date of the last evaluable tumor assessment on or prior to initiation of the subsequent anti-cancer therapy. Participants who did not have any on-study tumor assessments and did not die (or died after initiation of the subsequent anti-cancer therapy) will be censored at the randomization date. Participants who started any subsequent anti-cancer therapy without a prior reported PD per BICR will be censored at the last tumor assessment on or prior to initiation of the subsequent anti-cancer therapy.
Time frame: From the date of randomization to up to the date of the first documented disease progression or death (up to approximately 7 months)
Population: All randomized participants
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Arm A: Nivolumab + Ipilimumab | Progression-free Survival (PFS) in All Randomized Participants as Assessed by BICR | 2.92 Months |
| Arm B: Nivolumab + Chemotherapy | Progression-free Survival (PFS) in All Randomized Participants as Assessed by BICR | 5.82 Months |
| Arm C: Chemotherapy | Progression-free Survival (PFS) in All Randomized Participants as Assessed by BICR | 5.59 Months |