Melanoma
Conditions
Keywords
NKTR-214, Nivolumab, Immunotherapy, bempegaldesleukin (BEMPEG: NKTR-214)
Brief summary
The purpose of the study is to test the effectiveness (how well the drug works), safety, and tolerability of the investigational drug called NKTR-214, when combined with nivolumab versus nivolumab given alone in participants with previously untreated melanoma skin cancer that is either unable to be surgically removed or has spread
Interventions
Specified dose on specified days
Specified dose on specified days
Sponsors
Study design
Eligibility
Inclusion criteria
* Eastern Cooperative Oncology Group (ECOG) performance status of ≤1 (adults 18 years or older)/Lansky Performance Score ≥ 80% (minors ages 12-17 only) * Histologically confirmed stage III (unresectable) or stage IV melanoma * Treatment-naive participants (ie, no prior systemic anticancer therapy for unresectable or metastatic melanoma) with the exception of prior adjuvant and/or neoadjuvant treatment for melanoma with approved agents
Exclusion criteria
* Active brain metastases or leptomeningeal metastases * Uveal melanoma * Participants with an active, known or suspected autoimmune disease Other protocol defined inclusion/
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Objective Response Rate (ORR) Per Blinded Independent Central Review (BICR) | From date of randomization to disease progression (Up to 37 months) | ORR is defined as the percentage of participants with a confirmed best overall response of complete response (CR) or partial response (PR) using RECIST v 1.1 per blinded independent central review (BICR) assessment. 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. |
| Progression-free Survival (PFS) Per Blinded Independent Central Review (BICR) | From date of randomization to disease progression, or death, whichever comes first (Up to 37 months) | PFS is defined as the time between the date of randomization and the first date of documented tumor progression using RECIST v 1.1 per blinded independent central review (BICR), or death due to any cause, whichever comes first. Progressive disease (PD)=At least a 20% increase in the sum of diameters of target lesions. The sum must also demonstrate an absolute increase of at least 5 mm. |
| Overall Survival (OS) | From date of randomization to date of death (Up to 37 months) | OS is defined as the time between the date of randomization and the date of death due to any cause. Participants who do not have a date of death will be censored on the last date for which a participant was known to be alive. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Objective Response Rate (ORR) Per Investigator | From date of randomization to disease progression (Up to 37 months) | ORR is defined as the percentage of participants with a confirmed best overall response of complete response (CR) or partial response (PR) using RECIST v 1.1 per investigator assessment. 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. |
| Progression-free Survival (PFS) Per Investigator | From date of randomization to disease progression, or death, whichever comes first (Up to 37 months) | PFS is defined as the time between the date of randomization and the first date of documented tumor progression using RECIST v 1.1 per investigator, or death due to any cause, whichever comes first. Progressive disease (PD)=At least a 20% increase in the sum of diameters of target lesions. The sum must also demonstrate an absolute increase of at least 5 mm. |
| Clinical Benefit Rate (CBR) Per Investigator | From date of randomization to disease progression (Up to 37 months) | CBR, or equivalently the disease control rate (DCR) is defined as the percentage of participants with a best overall response of complete response (CR), partial response (PR), or stable disease (SD) as assessed by investigator using RECIST v 1.1. 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. SD=Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD. |
| Duration of Response (DoR) Per Investigator | From date of randomization to disease progression, or death, whichever is earlier (Up to 37 months) | DOR is defined for participants who have a confirmed complete response (CR) or partial results (PR) as the date from first documented CR or PR using RECIST v 1.1 to the date of the documentation of disease progression per investigator assessment or death due to any cause, whichever is earlier. 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. |
| Time to Objective Response (TTR) Per Investigator | From date of randomization to disease progression (Up to 37 months) | Time to response (TTR) is defined for participants who had a confirmed complete response (CR) or partial response (PR) as the time from the date of randomization to date of first documented CR or PR per investigator assessment using RECIST v 1.1. 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. |
| Clinical Benefit Rate (CBR) Per Blinded Independent Central Review (BICR) | From date of randomization to disease progression (Up to 37 months) | CBR, or equivalently the disease control rate (DCR) is defined as the percentage of participants with a best overall response of complete response (CR), partial response (PR), or stable disease (SD) as assessed by blinded independent central review (BICR) using RECIST v 1.1. 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.SD=Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for progressive disease. |
| Progression-free Survival (PFS) Per Blinded Independent Central Review (BICR) by Baseline PD-L1 Status | From date of randomization to disease progression, or death, whichever comes first (Up to 37 months) | PFS by baseline PD-L1 tumor cells expression (PD-L1 negative: \<1%) vs. (PD-L1 positive: \>=1%). PFS is defined as the time between the date of randomization and the first date of documented tumor progression using RECIST v 1.1 per blinded independent central review (BICR), or death due to any cause, whichever comes first. Progressive disease (PD)=At least a 20% increase in the sum of diameters of target lesions. The sum must also demonstrate an absolute increase of at least 5 mm. |
| Overall Survival (OS) by Baseline PD-L1 Status | From date of randomization to date of death (Up to 37 months) | OS by baseline PD-L1 tumor cells expression (PD-L1 negative: \<1%) vs. (PD-L1 positive: \>=1%). OS is defined as the time between the date of randomization and the date of death due to any cause. Participants who do not have a date of death will be censored on the last date for which a participant was known to be alive. |
| Number of Participants With Adverse Events (AEs) | From first dose to 30 days post last dose (Average of 11 months and a maximum up to 26 months) | Number of participants with any grade adverse events (AEs) including treatment-related AEs, AEs leading to discontinuation of any drug, serious adverse events (SAEs), treatment-related SAEs, and deaths from first dose to 30 days post last dose. An AE is defined as any new untoward medical occurrence or worsening of a preexisting medical condition in a clinical investigation participant administered study treatment and that does not necessarily have a causal relationship with this treatment. |
| Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | From first dose to 100 days post last dose (Average of 13 months and a maximum up to 28 months) | Number of participants with on-treatment laboratory parameters that worsened relative to baseline. Parameters include hematology, chemistry, liver function, and renal function using worst grade (grade 1-4 and grade 3-4) per national cancer institute (NCI) common terminology criteria for adverse events (CTCAE) v5 criteria. Grade 1=Mild event Grade 2=Moderate event Grade 3=Severe event Grade 4=Life threatening event |
| Objective Response Rate (ORR) Per Blinded Independent Central Review (BICR) by Baseline PD-L1 Status | From date of randomization to disease progression (Up to 37 months) | ORR by baseline PD-L1 tumor cells expression (PD-L1 negative: \<1%) vs. (PD-L1 positive: \>=1%). ORR is defined as the percentage of participants with a confirmed best overall response of complete response (CR) or partial response (PR) using RECIST v 1.1 per blinded independent central review (BICR) assessment. 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. |
| Duration of Response (DoR) Per Blinded Independent Central Review (BICR) | From date of randomization to disease progression, or death, whichever is earlier (Up to 37 months) | DOR is defined for participants who have a confirmed complete response (CR) or partial results (PR) as the date from first documented CR or PR using RECIST v 1.1 to the date of the documentation of disease progression per blinded independent central review (BICR) assessment or death due to any cause, whichever is earlier. 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. |
| Time to Objective Response (TTR) Per Blinded Independent Central Review (BICR) | From date of randomization to disease progression (Up to 37 months) | Time to response (TTR) is defined for participants who had a confirmed complete response (CR) or partial response (PR) as the time from the date of randomization to date of first documented CR or PR per blinded independent central review (BICR) assessment using RECIST v 1.1. 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. |
Countries
Argentina, Australia, Austria, Belgium, Brazil, Canada, Chile, Czechia, Finland, France, Germany, Greece, Ireland, Israel, Italy, Mexico, Netherlands, New Zealand, Poland, Portugal, Romania, Russia, Spain, Sweden, Switzerland, United Kingdom, United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Bempegaldesleukin + Nivolumab Bempegaldesleukin 0.006 mg/kg IV every 3 weeks + Nivolumab 360 mg IV every 3 weeks | 391 |
| Nivolumab Nivolumab 360 mg IV every 3 weeks | 392 |
| Total | 783 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Pre-Treatment Period | Adverse Event unrelated to Study drug | 2 | 1 |
| Pre-Treatment Period | Disease Progression | 0 | 1 |
| Pre-Treatment Period | Other reasons | 0 | 1 |
| Pre-Treatment Period | Participant no longer meets study criteria | 1 | 0 |
| Pre-Treatment Period | Withdrawal by Subject | 0 | 7 |
| Treatment Period | Administrative reason by the sponsor | 1 | 2 |
| Treatment Period | Adverse event unrelated to Study drug | 15 | 15 |
| Treatment Period | Death | 3 | 5 |
| Treatment Period | Disease progression | 230 | 201 |
| Treatment Period | Lost to Follow-up | 0 | 1 |
| Treatment Period | Maximum clinical benefit | 3 | 5 |
| Treatment Period | Other reasons | 7 | 4 |
| Treatment Period | Participant no longer meets Study criteria | 1 | 4 |
| Treatment Period | Participant request to discontinue Study treatment | 6 | 7 |
| Treatment Period | Poor/Non-compliance | 2 | 1 |
| Treatment Period | Study drug toxicity | 35 | 36 |
| Treatment Period | Withdrawal by Subject | 3 | 5 |
Baseline characteristics
| Characteristic | Bempegaldesleukin + Nivolumab | Nivolumab | Total |
|---|---|---|---|
| Age, Continuous | 61.3 Years STANDARD_DEVIATION 13.2 | 60.4 Years STANDARD_DEVIATION 13.5 | 60.8 Years STANDARD_DEVIATION 13.3 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 81 Participants | 73 Participants | 154 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 165 Participants | 153 Participants | 318 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 145 Participants | 166 Participants | 311 Participants |
| Race/Ethnicity, Customized American Indian or Alaska Native | 5 Participants | 2 Participants | 7 Participants |
| Race/Ethnicity, Customized Asian | 1 Participants | 0 Participants | 1 Participants |
| Race/Ethnicity, Customized Black or African American | 2 Participants | 4 Participants | 6 Participants |
| Race/Ethnicity, Customized Other | 4 Participants | 7 Participants | 11 Participants |
| Race/Ethnicity, Customized White | 379 Participants | 379 Participants | 758 Participants |
| Sex: Female, Male Female | 162 Participants | 163 Participants | 325 Participants |
| Sex: Female, Male Male | 229 Participants | 229 Participants | 458 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 170 / 391 | 173 / 392 |
| other Total, other adverse events | 357 / 388 | 336 / 382 |
| serious Total, serious adverse events | 161 / 388 | 172 / 382 |
Outcome results
Objective Response Rate (ORR) Per Blinded Independent Central Review (BICR)
ORR is defined as the percentage of participants with a confirmed best overall response of complete response (CR) or partial response (PR) using RECIST v 1.1 per blinded independent central review (BICR) assessment. 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.
Time frame: From date of randomization to disease progression (Up to 37 months)
Population: All randomized participants with at least 6 months of follow-up at the time point of the final ORR analysis. A follow-up time is defined as the time between randomization date and clinical data cut-off date.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Bempegaldesleukin + Nivolumab | Objective Response Rate (ORR) Per Blinded Independent Central Review (BICR) | 27.7 Percentage of participants |
| Nivolumab | Objective Response Rate (ORR) Per Blinded Independent Central Review (BICR) | 36.0 Percentage of participants |
Overall Survival (OS)
OS is defined as the time between the date of randomization and the date of death due to any cause. Participants who do not have a date of death will be censored on the last date for which a participant was known to be alive.
Time frame: From date of randomization to date of death (Up to 37 months)
Population: All randomized participants
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Bempegaldesleukin + Nivolumab | Overall Survival (OS) | 29.67 Months |
| Nivolumab | Overall Survival (OS) | 28.88 Months |
Progression-free Survival (PFS) Per Blinded Independent Central Review (BICR)
PFS is defined as the time between the date of randomization and the first date of documented tumor progression using RECIST v 1.1 per blinded independent central review (BICR), or death due to any cause, whichever comes first. Progressive disease (PD)=At least a 20% increase in the sum of diameters of target lesions. The sum must also demonstrate an absolute increase of at least 5 mm.
Time frame: From date of randomization to disease progression, or death, whichever comes first (Up to 37 months)
Population: All randomized participants
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Bempegaldesleukin + Nivolumab | Progression-free Survival (PFS) Per Blinded Independent Central Review (BICR) | 4.17 Months |
| Nivolumab | Progression-free Survival (PFS) Per Blinded Independent Central Review (BICR) | 4.99 Months |
Clinical Benefit Rate (CBR) Per Blinded Independent Central Review (BICR)
CBR, or equivalently the disease control rate (DCR) is defined as the percentage of participants with a best overall response of complete response (CR), partial response (PR), or stable disease (SD) as assessed by blinded independent central review (BICR) using RECIST v 1.1. 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.SD=Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for progressive disease.
Time frame: From date of randomization to disease progression (Up to 37 months)
Population: All randomized participants with at least 6 months of follow-up at the time point of the final ORR analysis. A follow-up time is defined as the time between randomization date and clinical data cut-off date.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Bempegaldesleukin + Nivolumab | Clinical Benefit Rate (CBR) Per Blinded Independent Central Review (BICR) | 56.1 Percentage of participants |
| Nivolumab | Clinical Benefit Rate (CBR) Per Blinded Independent Central Review (BICR) | 58.5 Percentage of participants |
Clinical Benefit Rate (CBR) Per Investigator
CBR, or equivalently the disease control rate (DCR) is defined as the percentage of participants with a best overall response of complete response (CR), partial response (PR), or stable disease (SD) as assessed by investigator using RECIST v 1.1. 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. SD=Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD.
Time frame: From date of randomization to disease progression (Up to 37 months)
Population: All randomized participants with at least 6 months of follow-up at the time point of the final ORR analysis. A follow-up time is defined as the time between randomization date and clinical data cut-off date.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Bempegaldesleukin + Nivolumab | Clinical Benefit Rate (CBR) Per Investigator | 60.5 Percentage of participants |
| Nivolumab | Clinical Benefit Rate (CBR) Per Investigator | 61.8 Percentage of participants |
Duration of Response (DoR) Per Blinded Independent Central Review (BICR)
DOR is defined for participants who have a confirmed complete response (CR) or partial results (PR) as the date from first documented CR or PR using RECIST v 1.1 to the date of the documentation of disease progression per blinded independent central review (BICR) assessment or death due to any cause, whichever is earlier. 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.
Time frame: From date of randomization to disease progression, or death, whichever is earlier (Up to 37 months)
Population: All randomized participants with partial or complete response and at least 6 months of follow-up at the time point of the final objective response rate analysis. A follow-up time is defined as the time between randomization date and clinical data cut-off date.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Bempegaldesleukin + Nivolumab | Duration of Response (DoR) Per Blinded Independent Central Review (BICR) | 29.67 Months |
| Nivolumab | Duration of Response (DoR) Per Blinded Independent Central Review (BICR) | NA Months |
Duration of Response (DoR) Per Investigator
DOR is defined for participants who have a confirmed complete response (CR) or partial results (PR) as the date from first documented CR or PR using RECIST v 1.1 to the date of the documentation of disease progression per investigator assessment or death due to any cause, whichever is earlier. 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.
Time frame: From date of randomization to disease progression, or death, whichever is earlier (Up to 37 months)
Population: All randomized participants with partial or complete response and at least 6 months of follow-up at the time point of the final objective response rate analysis. A follow-up time is defined as the time between randomization date and clinical data cut-off date.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Bempegaldesleukin + Nivolumab | Duration of Response (DoR) Per Investigator | NA Months |
| Nivolumab | Duration of Response (DoR) Per Investigator | NA Months |
Number of Participants With Adverse Events (AEs)
Number of participants with any grade adverse events (AEs) including treatment-related AEs, AEs leading to discontinuation of any drug, serious adverse events (SAEs), treatment-related SAEs, and deaths from first dose to 30 days post last dose. An AE is defined as any new untoward medical occurrence or worsening of a preexisting medical condition in a clinical investigation participant administered study treatment and that does not necessarily have a causal relationship with this treatment.
Time frame: From first dose to 30 days post last dose (Average of 11 months and a maximum up to 26 months)
Population: All treated participants
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Bempegaldesleukin + Nivolumab | Number of Participants With Adverse Events (AEs) | AEs | 378 Participants |
| Bempegaldesleukin + Nivolumab | Number of Participants With Adverse Events (AEs) | Drug-related AEs | 351 Participants |
| Bempegaldesleukin + Nivolumab | Number of Participants With Adverse Events (AEs) | SAEs | 132 Participants |
| Bempegaldesleukin + Nivolumab | Number of Participants With Adverse Events (AEs) | Drug-related SAEs | 57 Participants |
| Bempegaldesleukin + Nivolumab | Number of Participants With Adverse Events (AEs) | AEs leading to discontinuation of any Drug | 65 Participants |
| Bempegaldesleukin + Nivolumab | Number of Participants With Adverse Events (AEs) | Deaths | 21 Participants |
| Nivolumab | Number of Participants With Adverse Events (AEs) | AEs leading to discontinuation of any Drug | 56 Participants |
| Nivolumab | Number of Participants With Adverse Events (AEs) | AEs | 364 Participants |
| Nivolumab | Number of Participants With Adverse Events (AEs) | Drug-related SAEs | 32 Participants |
| Nivolumab | Number of Participants With Adverse Events (AEs) | Drug-related AEs | 281 Participants |
| Nivolumab | Number of Participants With Adverse Events (AEs) | Deaths | 21 Participants |
| Nivolumab | Number of Participants With Adverse Events (AEs) | SAEs | 130 Participants |
Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline
Number of participants with on-treatment laboratory parameters that worsened relative to baseline. Parameters include hematology, chemistry, liver function, and renal function using worst grade (grade 1-4 and grade 3-4) per national cancer institute (NCI) common terminology criteria for adverse events (CTCAE) v5 criteria. Grade 1=Mild event Grade 2=Moderate event Grade 3=Severe event Grade 4=Life threatening event
Time frame: From first dose to 100 days post last dose (Average of 13 months and a maximum up to 28 months)
Population: All treated participants with laboratory baseline measures
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Bempegaldesleukin + Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Neutrophils (absolute) decreased grade 1-4 | 57 Participants |
| Bempegaldesleukin + Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Hemoglobin decreased grade 3-4 | 17 Participants |
| Bempegaldesleukin + Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Platelet count decreased grade 1-4 | 36 Participants |
| Bempegaldesleukin + Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Platelet count decreased grade 3-4 | 2 Participants |
| Bempegaldesleukin + Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Leukocytes decreased grade 1-4 | 29 Participants |
| Bempegaldesleukin + Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Leukocytes decreased grade 3-4 | 2 Participants |
| Bempegaldesleukin + Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Lymphocytes (absolute) decreased grade 1-4 | 304 Participants |
| Bempegaldesleukin + Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Lymphocytes (absolute) decreased grade 3-4 | 199 Participants |
| Bempegaldesleukin + Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Absolute Neutrophil count decreased grade 1-4 | 71 Participants |
| Bempegaldesleukin + Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Absolute Neutrophil, count decreased grade 3-4 | 8 Participants |
| Bempegaldesleukin + Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Hemoglobin decreased grade 1-4 | 194 Participants |
| Bempegaldesleukin + Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Neutrophils (absolute) decreased grade 3-4 | 10 Participants |
| Bempegaldesleukin + Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Alkaline Phosphatase increased grade 1-4 | 96 Participants |
| Bempegaldesleukin + Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Alkaline Phosphatase increased grade 3-4 | 2 Participants |
| Bempegaldesleukin + Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Aspartate Aminotransferase increased grade 1-4 | 96 Participants |
| Bempegaldesleukin + Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Aspartate Aminotransferase increased grade 3-4 | 9 Participants |
| Bempegaldesleukin + Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Alanine Aminotransferase increased grade 1-4 | 104 Participants |
| Bempegaldesleukin + Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Alanine Aminotransferase increased grade 3-4 | 11 Participants |
| Bempegaldesleukin + Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Bilirubin, total increased grade 1-4 | 36 Participants |
| Bempegaldesleukin + Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Bilirubin, total increased grade 3-4 | 2 Participants |
| Bempegaldesleukin + Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Creatinine increased grade 1-4 | 81 Participants |
| Bempegaldesleukin + Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Creatinine increased grade 3-4 | 2 Participants |
| Bempegaldesleukin + Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Amylase increased grade 1-4 | 51 Participants |
| Bempegaldesleukin + Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Amylase increased grade 3-4 | 3 Participants |
| Bempegaldesleukin + Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Lipase, total increased grade 1-4 | 90 Participants |
| Bempegaldesleukin + Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Lipase, total increased grade 3-4 | 17 Participants |
| Bempegaldesleukin + Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Hypernatremia grade 1-4 | 29 Participants |
| Bempegaldesleukin + Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Hypernatremia grade 3-4 | 2 Participants |
| Bempegaldesleukin + Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Hyponatremia grade 1-4 | 112 Participants |
| Bempegaldesleukin + Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Hyponatremia grade 3-4 | 6 Participants |
| Bempegaldesleukin + Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Hyperkalemia grade 1-4 | 91 Participants |
| Bempegaldesleukin + Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Hyperkalemia grade 3-4 | 9 Participants |
| Bempegaldesleukin + Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Hypokalemia grade 1-4 | 32 Participants |
| Bempegaldesleukin + Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Hypokalemia grade 3-4 | 5 Participants |
| Bempegaldesleukin + Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Hypercalcemia grade 1-4 | 45 Participants |
| Bempegaldesleukin + Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Hypercalcemia grade 3-4 | 1 Participants |
| Bempegaldesleukin + Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Hypocalcemia grade 1-4 | 78 Participants |
| Bempegaldesleukin + Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Hypocalcemia grade 3-4 | 5 Participants |
| Bempegaldesleukin + Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Hypoglycemia grade 1-4 | 42 Participants |
| Bempegaldesleukin + Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Hypoglycemia grade 3-4 | 3 Participants |
| Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Hypocalcemia grade 3-4 | 0 Participants |
| Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Hemoglobin decreased grade 1-4 | 173 Participants |
| Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Creatinine increased grade 1-4 | 94 Participants |
| Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Hemoglobin decreased grade 3-4 | 22 Participants |
| Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Hyperkalemia grade 1-4 | 85 Participants |
| Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Platelet count decreased grade 1-4 | 41 Participants |
| Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Creatinine increased grade 3-4 | 6 Participants |
| Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Platelet count decreased grade 3-4 | 6 Participants |
| Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Hypercalcemia grade 3-4 | 0 Participants |
| Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Leukocytes decreased grade 1-4 | 46 Participants |
| Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Amylase increased grade 1-4 | 78 Participants |
| Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Leukocytes decreased grade 3-4 | 2 Participants |
| Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Hyperkalemia grade 3-4 | 6 Participants |
| Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Lymphocytes (absolute) decreased grade 1-4 | 194 Participants |
| Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Amylase increased grade 3-4 | 6 Participants |
| Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Lymphocytes (absolute) decreased grade 3-4 | 30 Participants |
| Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Hypoglycemia grade 3-4 | 0 Participants |
| Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Absolute Neutrophil count decreased grade 1-4 | 31 Participants |
| Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Lipase, total increased grade 1-4 | 126 Participants |
| Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Absolute Neutrophil, count decreased grade 3-4 | 2 Participants |
| Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Hypokalemia grade 1-4 | 51 Participants |
| Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Neutrophils (absolute) decreased grade 1-4 | 29 Participants |
| Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Lipase, total increased grade 3-4 | 17 Participants |
| Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Neutrophils (absolute) decreased grade 3-4 | 2 Participants |
| Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Hypocalcemia grade 1-4 | 82 Participants |
| Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Alkaline Phosphatase increased grade 1-4 | 90 Participants |
| Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Hypernatremia grade 1-4 | 47 Participants |
| Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Alkaline Phosphatase increased grade 3-4 | 6 Participants |
| Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Hypokalemia grade 3-4 | 2 Participants |
| Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Aspartate Aminotransferase increased grade 1-4 | 115 Participants |
| Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Hypernatremia grade 3-4 | 0 Participants |
| Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Aspartate Aminotransferase increased grade 3-4 | 17 Participants |
| Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Hypoglycemia grade 1-4 | 39 Participants |
| Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Alanine Aminotransferase increased grade 1-4 | 132 Participants |
| Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Hyponatremia grade 1-4 | 123 Participants |
| Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Alanine Aminotransferase increased grade 3-4 | 13 Participants |
| Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Hypercalcemia grade 1-4 | 45 Participants |
| Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Bilirubin, total increased grade 1-4 | 46 Participants |
| Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Hyponatremia grade 3-4 | 11 Participants |
| Nivolumab | Number of Participants With On-Treatment Laboratory Parameters That Worsened Relative to Baseline | Bilirubin, total increased grade 3-4 | 4 Participants |
Objective Response Rate (ORR) Per Blinded Independent Central Review (BICR) by Baseline PD-L1 Status
ORR by baseline PD-L1 tumor cells expression (PD-L1 negative: \<1%) vs. (PD-L1 positive: \>=1%). ORR is defined as the percentage of participants with a confirmed best overall response of complete response (CR) or partial response (PR) using RECIST v 1.1 per blinded independent central review (BICR) assessment. 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.
Time frame: From date of randomization to disease progression (Up to 37 months)
Population: All randomized participants with PD-L1 data available at baseline and at least 6 months of follow-up at the time point of the final objective response rate analysis. A follow-up time is defined as the time between randomization date and clinical data cut-off date
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Bempegaldesleukin + Nivolumab | Objective Response Rate (ORR) Per Blinded Independent Central Review (BICR) by Baseline PD-L1 Status | Participants with baseline PD-L1 expression <1% | 17.6 Percentage of participants |
| Bempegaldesleukin + Nivolumab | Objective Response Rate (ORR) Per Blinded Independent Central Review (BICR) by Baseline PD-L1 Status | Participants with baseline PD-L1 expression >=1% | 36.4 Percentage of participants |
| Nivolumab | Objective Response Rate (ORR) Per Blinded Independent Central Review (BICR) by Baseline PD-L1 Status | Participants with baseline PD-L1 expression <1% | 25.2 Percentage of participants |
| Nivolumab | Objective Response Rate (ORR) Per Blinded Independent Central Review (BICR) by Baseline PD-L1 Status | Participants with baseline PD-L1 expression >=1% | 47.5 Percentage of participants |
Objective Response Rate (ORR) Per Investigator
ORR is defined as the percentage of participants with a confirmed best overall response of complete response (CR) or partial response (PR) using RECIST v 1.1 per investigator assessment. 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.
Time frame: From date of randomization to disease progression (Up to 37 months)
Population: All randomized participants with at least 6 months of follow-up at the time point of the final ORR analysis. A follow-up time is defined as the time between randomization date and clinical data cut-off date.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Bempegaldesleukin + Nivolumab | Objective Response Rate (ORR) Per Investigator | 29.2 Percentage of participants |
| Nivolumab | Objective Response Rate (ORR) Per Investigator | 36.4 Percentage of participants |
Overall Survival (OS) by Baseline PD-L1 Status
OS by baseline PD-L1 tumor cells expression (PD-L1 negative: \<1%) vs. (PD-L1 positive: \>=1%). OS is defined as the time between the date of randomization and the date of death due to any cause. Participants who do not have a date of death will be censored on the last date for which a participant was known to be alive.
Time frame: From date of randomization to date of death (Up to 37 months)
Population: All randomized participants with PD-L1 data available at baseline
| Arm | Measure | Group | Value (MEDIAN) |
|---|---|---|---|
| Bempegaldesleukin + Nivolumab | Overall Survival (OS) by Baseline PD-L1 Status | Participants with baseline PD-L1 expression <1% | 21.16 Months |
| Bempegaldesleukin + Nivolumab | Overall Survival (OS) by Baseline PD-L1 Status | Participants with baseline PD-L1 expression >=1% | NA Months |
| Nivolumab | Overall Survival (OS) by Baseline PD-L1 Status | Participants with baseline PD-L1 expression <1% | 21.13 Months |
| Nivolumab | Overall Survival (OS) by Baseline PD-L1 Status | Participants with baseline PD-L1 expression >=1% | NA Months |
Progression-free Survival (PFS) Per Blinded Independent Central Review (BICR) by Baseline PD-L1 Status
PFS by baseline PD-L1 tumor cells expression (PD-L1 negative: \<1%) vs. (PD-L1 positive: \>=1%). PFS is defined as the time between the date of randomization and the first date of documented tumor progression using RECIST v 1.1 per blinded independent central review (BICR), or death due to any cause, whichever comes first. Progressive disease (PD)=At least a 20% increase in the sum of diameters of target lesions. The sum must also demonstrate an absolute increase of at least 5 mm.
Time frame: From date of randomization to disease progression, or death, whichever comes first (Up to 37 months)
Population: All randomized participants with PD-L1 data available at baseline
| Arm | Measure | Group | Value (MEDIAN) |
|---|---|---|---|
| Bempegaldesleukin + Nivolumab | Progression-free Survival (PFS) Per Blinded Independent Central Review (BICR) by Baseline PD-L1 Status | Participants with baseline PD-L1 expression <1% | 3.25 Months |
| Bempegaldesleukin + Nivolumab | Progression-free Survival (PFS) Per Blinded Independent Central Review (BICR) by Baseline PD-L1 Status | Participants with baseline PD-L1 expression >=1% | 6.24 Months |
| Nivolumab | Progression-free Survival (PFS) Per Blinded Independent Central Review (BICR) by Baseline PD-L1 Status | Participants with baseline PD-L1 expression <1% | 2.30 Months |
| Nivolumab | Progression-free Survival (PFS) Per Blinded Independent Central Review (BICR) by Baseline PD-L1 Status | Participants with baseline PD-L1 expression >=1% | 10.51 Months |
Progression-free Survival (PFS) Per Investigator
PFS is defined as the time between the date of randomization and the first date of documented tumor progression using RECIST v 1.1 per investigator, or death due to any cause, whichever comes first. Progressive disease (PD)=At least a 20% increase in the sum of diameters of target lesions. The sum must also demonstrate an absolute increase of at least 5 mm.
Time frame: From date of randomization to disease progression, or death, whichever comes first (Up to 37 months)
Population: All randomized participants
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Bempegaldesleukin + Nivolumab | Progression-free Survival (PFS) Per Investigator | 4.27 Months |
| Nivolumab | Progression-free Survival (PFS) Per Investigator | 6.21 Months |
Time to Objective Response (TTR) Per Blinded Independent Central Review (BICR)
Time to response (TTR) is defined for participants who had a confirmed complete response (CR) or partial response (PR) as the time from the date of randomization to date of first documented CR or PR per blinded independent central review (BICR) assessment using RECIST v 1.1. 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.
Time frame: From date of randomization to disease progression (Up to 37 months)
Population: All randomized participants with partial or complete response and at least 6 months of follow-up at the time point of the final objective response rate analysis. A follow-up time is defined as the time between randomization date and clinical data cut-off date.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Bempegaldesleukin + Nivolumab | Time to Objective Response (TTR) Per Blinded Independent Central Review (BICR) | 2.17 Months |
| Nivolumab | Time to Objective Response (TTR) Per Blinded Independent Central Review (BICR) | 2.20 Months |
Time to Objective Response (TTR) Per Investigator
Time to response (TTR) is defined for participants who had a confirmed complete response (CR) or partial response (PR) as the time from the date of randomization to date of first documented CR or PR per investigator assessment using RECIST v 1.1. 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.
Time frame: From date of randomization to disease progression (Up to 37 months)
Population: All randomized participants with partial or complete response and at least 6 months of follow-up at the time point of the final objective response rate analysis. A follow-up time is defined as the time between randomization date and clinical data cut-off date
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Bempegaldesleukin + Nivolumab | Time to Objective Response (TTR) Per Investigator | 2.14 Months |
| Nivolumab | Time to Objective Response (TTR) Per Investigator | 2.14 Months |