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A Study of NKTR-214 Combined With Nivolumab vs Nivolumab Alone in Participants With Previously Untreated Inoperable or Metastatic Melanoma

A Phase 3, Randomized, Open-label Study of NKTR-214 Combined With Nivolumab Versus Nivolumab in Participants With Previously Untreated Unresectable or Metastatic Melanoma

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT03635983
Enrollment
783
Registered
2018-08-17
Start date
2018-09-21
Completion date
2024-03-19
Last updated
2025-04-01

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

Conditions

Melanoma

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

BIOLOGICALNivolumab

Specified dose on specified days

BIOLOGICALNKTR-214

Specified dose on specified days

Sponsors

Nektar Therapeutics
CollaboratorINDUSTRY
Bristol-Myers Squibb
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
12 Years to No maximum
Healthy volunteers
No

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

MeasureTime frameDescription
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

MeasureTime frameDescription
Objective Response Rate (ORR) Per InvestigatorFrom 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 InvestigatorFrom 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 InvestigatorFrom 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 InvestigatorFrom 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 InvestigatorFrom 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 StatusFrom 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 StatusFrom 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 BaselineFrom 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 StatusFrom 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

ArmCount
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
Total783

Withdrawals & dropouts

PeriodReasonFG000FG001
Pre-Treatment PeriodAdverse Event unrelated to Study drug21
Pre-Treatment PeriodDisease Progression01
Pre-Treatment PeriodOther reasons01
Pre-Treatment PeriodParticipant no longer meets study criteria10
Pre-Treatment PeriodWithdrawal by Subject07
Treatment PeriodAdministrative reason by the sponsor12
Treatment PeriodAdverse event unrelated to Study drug1515
Treatment PeriodDeath35
Treatment PeriodDisease progression230201
Treatment PeriodLost to Follow-up01
Treatment PeriodMaximum clinical benefit35
Treatment PeriodOther reasons74
Treatment PeriodParticipant no longer meets Study criteria14
Treatment PeriodParticipant request to discontinue Study treatment67
Treatment PeriodPoor/Non-compliance21
Treatment PeriodStudy drug toxicity3536
Treatment PeriodWithdrawal by Subject35

Baseline characteristics

CharacteristicBempegaldesleukin + NivolumabNivolumabTotal
Age, Continuous61.3 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 Participants73 Participants154 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
165 Participants153 Participants318 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
145 Participants166 Participants311 Participants
Race/Ethnicity, Customized
American Indian or Alaska Native
5 Participants2 Participants7 Participants
Race/Ethnicity, Customized
Asian
1 Participants0 Participants1 Participants
Race/Ethnicity, Customized
Black or African American
2 Participants4 Participants6 Participants
Race/Ethnicity, Customized
Other
4 Participants7 Participants11 Participants
Race/Ethnicity, Customized
White
379 Participants379 Participants758 Participants
Sex: Female, Male
Female
162 Participants163 Participants325 Participants
Sex: Female, Male
Male
229 Participants229 Participants458 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
170 / 391173 / 392
other
Total, other adverse events
357 / 388336 / 382
serious
Total, serious adverse events
161 / 388172 / 382

Outcome results

Primary

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.

ArmMeasureValue (NUMBER)
Bempegaldesleukin + NivolumabObjective Response Rate (ORR) Per Blinded Independent Central Review (BICR)27.7 Percentage of participants
NivolumabObjective Response Rate (ORR) Per Blinded Independent Central Review (BICR)36.0 Percentage of participants
Comparison: Bempegaldesleukin+Nivolumab over Nivolumabp-value: 0.031195% CI: [0.45, 0.96]Stratified Cochran-Mantel-Haenszel
Primary

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

ArmMeasureValue (MEDIAN)
Bempegaldesleukin + NivolumabOverall Survival (OS)29.67 Months
NivolumabOverall Survival (OS)28.88 Months
p-value: 0.636195% CI: [0.72, 1.22]Log Rank
Primary

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

ArmMeasureValue (MEDIAN)
Bempegaldesleukin + NivolumabProgression-free Survival (PFS) Per Blinded Independent Central Review (BICR)4.17 Months
NivolumabProgression-free Survival (PFS) Per Blinded Independent Central Review (BICR)4.99 Months
p-value: 0.398895% CI: [0.89, 1.33]Log Rank
Secondary

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.

ArmMeasureValue (NUMBER)
Bempegaldesleukin + NivolumabClinical Benefit Rate (CBR) Per Blinded Independent Central Review (BICR)56.1 Percentage of participants
NivolumabClinical Benefit Rate (CBR) Per Blinded Independent Central Review (BICR)58.5 Percentage of participants
Secondary

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.

ArmMeasureValue (NUMBER)
Bempegaldesleukin + NivolumabClinical Benefit Rate (CBR) Per Investigator60.5 Percentage of participants
NivolumabClinical Benefit Rate (CBR) Per Investigator61.8 Percentage of participants
Secondary

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.

ArmMeasureValue (MEDIAN)
Bempegaldesleukin + NivolumabDuration of Response (DoR) Per Blinded Independent Central Review (BICR)29.67 Months
NivolumabDuration of Response (DoR) Per Blinded Independent Central Review (BICR)NA Months
Secondary

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.

ArmMeasureValue (MEDIAN)
Bempegaldesleukin + NivolumabDuration of Response (DoR) Per InvestigatorNA Months
NivolumabDuration of Response (DoR) Per InvestigatorNA Months
Secondary

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

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Bempegaldesleukin + NivolumabNumber of Participants With Adverse Events (AEs)AEs378 Participants
Bempegaldesleukin + NivolumabNumber of Participants With Adverse Events (AEs)Drug-related AEs351 Participants
Bempegaldesleukin + NivolumabNumber of Participants With Adverse Events (AEs)SAEs132 Participants
Bempegaldesleukin + NivolumabNumber of Participants With Adverse Events (AEs)Drug-related SAEs57 Participants
Bempegaldesleukin + NivolumabNumber of Participants With Adverse Events (AEs)AEs leading to discontinuation of any Drug65 Participants
Bempegaldesleukin + NivolumabNumber of Participants With Adverse Events (AEs)Deaths21 Participants
NivolumabNumber of Participants With Adverse Events (AEs)AEs leading to discontinuation of any Drug56 Participants
NivolumabNumber of Participants With Adverse Events (AEs)AEs364 Participants
NivolumabNumber of Participants With Adverse Events (AEs)Drug-related SAEs32 Participants
NivolumabNumber of Participants With Adverse Events (AEs)Drug-related AEs281 Participants
NivolumabNumber of Participants With Adverse Events (AEs)Deaths21 Participants
NivolumabNumber of Participants With Adverse Events (AEs)SAEs130 Participants
Secondary

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

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Bempegaldesleukin + NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineNeutrophils (absolute) decreased grade 1-457 Participants
Bempegaldesleukin + NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineHemoglobin decreased grade 3-417 Participants
Bempegaldesleukin + NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselinePlatelet count decreased grade 1-436 Participants
Bempegaldesleukin + NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselinePlatelet count decreased grade 3-42 Participants
Bempegaldesleukin + NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineLeukocytes decreased grade 1-429 Participants
Bempegaldesleukin + NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineLeukocytes decreased grade 3-42 Participants
Bempegaldesleukin + NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineLymphocytes (absolute) decreased grade 1-4304 Participants
Bempegaldesleukin + NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineLymphocytes (absolute) decreased grade 3-4199 Participants
Bempegaldesleukin + NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineAbsolute Neutrophil count decreased grade 1-471 Participants
Bempegaldesleukin + NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineAbsolute Neutrophil, count decreased grade 3-48 Participants
Bempegaldesleukin + NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineHemoglobin decreased grade 1-4194 Participants
Bempegaldesleukin + NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineNeutrophils (absolute) decreased grade 3-410 Participants
Bempegaldesleukin + NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineAlkaline Phosphatase increased grade 1-496 Participants
Bempegaldesleukin + NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineAlkaline Phosphatase increased grade 3-42 Participants
Bempegaldesleukin + NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineAspartate Aminotransferase increased grade 1-496 Participants
Bempegaldesleukin + NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineAspartate Aminotransferase increased grade 3-49 Participants
Bempegaldesleukin + NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineAlanine Aminotransferase increased grade 1-4104 Participants
Bempegaldesleukin + NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineAlanine Aminotransferase increased grade 3-411 Participants
Bempegaldesleukin + NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineBilirubin, total increased grade 1-436 Participants
Bempegaldesleukin + NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineBilirubin, total increased grade 3-42 Participants
Bempegaldesleukin + NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineCreatinine increased grade 1-481 Participants
Bempegaldesleukin + NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineCreatinine increased grade 3-42 Participants
Bempegaldesleukin + NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineAmylase increased grade 1-451 Participants
Bempegaldesleukin + NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineAmylase increased grade 3-43 Participants
Bempegaldesleukin + NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineLipase, total increased grade 1-490 Participants
Bempegaldesleukin + NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineLipase, total increased grade 3-417 Participants
Bempegaldesleukin + NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineHypernatremia grade 1-429 Participants
Bempegaldesleukin + NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineHypernatremia grade 3-42 Participants
Bempegaldesleukin + NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineHyponatremia grade 1-4112 Participants
Bempegaldesleukin + NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineHyponatremia grade 3-46 Participants
Bempegaldesleukin + NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineHyperkalemia grade 1-491 Participants
Bempegaldesleukin + NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineHyperkalemia grade 3-49 Participants
Bempegaldesleukin + NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineHypokalemia grade 1-432 Participants
Bempegaldesleukin + NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineHypokalemia grade 3-45 Participants
Bempegaldesleukin + NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineHypercalcemia grade 1-445 Participants
Bempegaldesleukin + NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineHypercalcemia grade 3-41 Participants
Bempegaldesleukin + NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineHypocalcemia grade 1-478 Participants
Bempegaldesleukin + NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineHypocalcemia grade 3-45 Participants
Bempegaldesleukin + NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineHypoglycemia grade 1-442 Participants
Bempegaldesleukin + NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineHypoglycemia grade 3-43 Participants
NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineHypocalcemia grade 3-40 Participants
NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineHemoglobin decreased grade 1-4173 Participants
NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineCreatinine increased grade 1-494 Participants
NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineHemoglobin decreased grade 3-422 Participants
NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineHyperkalemia grade 1-485 Participants
NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselinePlatelet count decreased grade 1-441 Participants
NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineCreatinine increased grade 3-46 Participants
NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselinePlatelet count decreased grade 3-46 Participants
NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineHypercalcemia grade 3-40 Participants
NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineLeukocytes decreased grade 1-446 Participants
NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineAmylase increased grade 1-478 Participants
NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineLeukocytes decreased grade 3-42 Participants
NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineHyperkalemia grade 3-46 Participants
NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineLymphocytes (absolute) decreased grade 1-4194 Participants
NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineAmylase increased grade 3-46 Participants
NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineLymphocytes (absolute) decreased grade 3-430 Participants
NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineHypoglycemia grade 3-40 Participants
NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineAbsolute Neutrophil count decreased grade 1-431 Participants
NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineLipase, total increased grade 1-4126 Participants
NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineAbsolute Neutrophil, count decreased grade 3-42 Participants
NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineHypokalemia grade 1-451 Participants
NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineNeutrophils (absolute) decreased grade 1-429 Participants
NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineLipase, total increased grade 3-417 Participants
NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineNeutrophils (absolute) decreased grade 3-42 Participants
NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineHypocalcemia grade 1-482 Participants
NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineAlkaline Phosphatase increased grade 1-490 Participants
NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineHypernatremia grade 1-447 Participants
NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineAlkaline Phosphatase increased grade 3-46 Participants
NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineHypokalemia grade 3-42 Participants
NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineAspartate Aminotransferase increased grade 1-4115 Participants
NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineHypernatremia grade 3-40 Participants
NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineAspartate Aminotransferase increased grade 3-417 Participants
NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineHypoglycemia grade 1-439 Participants
NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineAlanine Aminotransferase increased grade 1-4132 Participants
NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineHyponatremia grade 1-4123 Participants
NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineAlanine Aminotransferase increased grade 3-413 Participants
NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineHypercalcemia grade 1-445 Participants
NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineBilirubin, total increased grade 1-446 Participants
NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineHyponatremia grade 3-411 Participants
NivolumabNumber of Participants With On-Treatment Laboratory Parameters That Worsened Relative to BaselineBilirubin, total increased grade 3-44 Participants
Secondary

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

ArmMeasureGroupValue (NUMBER)
Bempegaldesleukin + NivolumabObjective Response Rate (ORR) Per Blinded Independent Central Review (BICR) by Baseline PD-L1 StatusParticipants with baseline PD-L1 expression <1%17.6 Percentage of participants
Bempegaldesleukin + NivolumabObjective Response Rate (ORR) Per Blinded Independent Central Review (BICR) by Baseline PD-L1 StatusParticipants with baseline PD-L1 expression >=1%36.4 Percentage of participants
NivolumabObjective Response Rate (ORR) Per Blinded Independent Central Review (BICR) by Baseline PD-L1 StatusParticipants with baseline PD-L1 expression <1%25.2 Percentage of participants
NivolumabObjective Response Rate (ORR) Per Blinded Independent Central Review (BICR) by Baseline PD-L1 StatusParticipants with baseline PD-L1 expression >=1%47.5 Percentage of participants
Comparison: Bempegaldesleukin+Nivolumab vs. Nivolumab (PD-L1 Negative: \<1%)95% CI: [0.32, 1.24]
Comparison: Bempegaldesleukin+Nivolumab vs. Nivolumab (PD-L1 Positive: \>=1%)p-value: 0.993995% CI: [0.39, 1.02]Stratified Cochran-Mantel-Haenszel
Secondary

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.

ArmMeasureValue (NUMBER)
Bempegaldesleukin + NivolumabObjective Response Rate (ORR) Per Investigator29.2 Percentage of participants
NivolumabObjective Response Rate (ORR) Per Investigator36.4 Percentage of participants
Comparison: Bempegaldesleukin+Nivolumab over Nivolumabp-value: 0.062695% CI: [0.48, 1.02]Stratified Cochran-Mantel-Haenszel
Secondary

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

ArmMeasureGroupValue (MEDIAN)
Bempegaldesleukin + NivolumabOverall Survival (OS) by Baseline PD-L1 StatusParticipants with baseline PD-L1 expression <1%21.16 Months
Bempegaldesleukin + NivolumabOverall Survival (OS) by Baseline PD-L1 StatusParticipants with baseline PD-L1 expression >=1%NA Months
NivolumabOverall Survival (OS) by Baseline PD-L1 StatusParticipants with baseline PD-L1 expression <1%21.13 Months
NivolumabOverall Survival (OS) by Baseline PD-L1 StatusParticipants with baseline PD-L1 expression >=1%NA Months
Comparison: Bempegaldesleukin+Nivolumab vs. Nivo (PD-L1 negative: \<1%)95% CI: [0.66, 1.4]
Comparison: Bempegaldesleukin+Nivolumab vs. Nivo (PD-L1 positive: \>=1%)95% CI: [0.58, 1.33]
Secondary

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

ArmMeasureGroupValue (MEDIAN)
Bempegaldesleukin + NivolumabProgression-free Survival (PFS) Per Blinded Independent Central Review (BICR) by Baseline PD-L1 StatusParticipants with baseline PD-L1 expression <1%3.25 Months
Bempegaldesleukin + NivolumabProgression-free Survival (PFS) Per Blinded Independent Central Review (BICR) by Baseline PD-L1 StatusParticipants with baseline PD-L1 expression >=1%6.24 Months
NivolumabProgression-free Survival (PFS) Per Blinded Independent Central Review (BICR) by Baseline PD-L1 StatusParticipants with baseline PD-L1 expression <1%2.30 Months
NivolumabProgression-free Survival (PFS) Per Blinded Independent Central Review (BICR) by Baseline PD-L1 StatusParticipants with baseline PD-L1 expression >=1%10.51 Months
Comparison: Bempegaldesleukin+Nivolumab vs. Nivo (PD-L1 negative: \<1%)95% CI: [0.81, 1.43]
Comparison: Bempegaldesleukin+Nivolumab vs. Nivo (PD-L1 positive: \>=1%)95% CI: [0.83, 1.51]
Secondary

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

ArmMeasureValue (MEDIAN)
Bempegaldesleukin + NivolumabProgression-free Survival (PFS) Per Investigator4.27 Months
NivolumabProgression-free Survival (PFS) Per Investigator6.21 Months
p-value: 0.371395% CI: [0.9, 1.33]Log Rank
Secondary

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.

ArmMeasureValue (MEDIAN)
Bempegaldesleukin + NivolumabTime to Objective Response (TTR) Per Blinded Independent Central Review (BICR)2.17 Months
NivolumabTime to Objective Response (TTR) Per Blinded Independent Central Review (BICR)2.20 Months
Secondary

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

ArmMeasureValue (MEDIAN)
Bempegaldesleukin + NivolumabTime to Objective Response (TTR) Per Investigator2.14 Months
NivolumabTime to Objective Response (TTR) Per Investigator2.14 Months

Source: ClinicalTrials.gov · Data processed: Feb 21, 2026