Safety and efficacy of nivolumab in patients with rare melanoma subtypes who progressed on or after ipilimumab treatment: a single-arm, open-label, phase II study (CheckMate 172)

Paul Nathan, Paolo A. Ascierto, John Haanen, Enrique Espinosa, Lev Demidov, Claus Garbe, Michele Guida, Paul Lorigan, Vanna Chiarion-Sileni, Helen Gogas, Michele Maio, Maria Teresa Fierro, Christoph Hoeller, Patrick Terheyden, Ralf Gutzmer, Tormod K. Guren, Dimitrios Bafaloukos, Piotr Rutkowski, Ruth Plummer, Ashita WaterstonMartin Kaatz, Mario Mandala, Ivan Marquez-Rodas, Eva Muñoz-Couselo, Reinhard Dummer, Elena Grigoryeva, Tina C. Young, Dirk Schadendorf

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Nivolumab has been widely studied in non-acral cutaneous melanoma; however, limited data are available in other melanoma subtypes. We report outcomes by melanoma subtype in patients who received nivolumab after progression on prior ipilimumab. Patients and methods: CheckMate 172 was a phase II, single-arm, open-label, multicentre study that evaluated nivolumab in patients with advanced melanoma who progressed on or after ipilimumab. Patients received 3 mg/kg of nivolumab, every 2 weeks for up to 2 years. The primary end-point was incidence of grade ≥3, treatment-related select adverse events (AEs). Results: Among 1008 treated patients, we report data on patients with non-acral cutaneous melanoma (n = 723 [71.7%]), ocular melanoma (n = 103 [10.2%]), mucosal melanoma (n = 63 [6.3%]), acral cutaneous melanoma (n = 55 [5.5%]) and other melanoma subtypes (n = 64 [6.3%]). There were no meaningful differences in the incidence of grade ≥3, treatment-related select AEs among melanoma subtypes or compared with the total population. No new safety signals emerged. At a minimum follow-up of 18 months, median overall survival was 25.3 months for non-acral cutaneous melanoma and 25.8 months for acral cutaneous melanoma, with 18-month overall survival rates of 57.5% and 59.0%, respectively. Median overall survival was 12.6 months for ocular melanoma and 11.5 months for mucosal melanoma, with 18-month overall survival rates of 34.8% and 31.5%, respectively. Conclusions: The safety profile of nivolumab after ipilimumab is similar across melanoma subtypes. Compared with non-acral cutaneous melanoma, patients with acral cutaneous melanoma had similar survival outcomes, whereas those with ocular and mucosal melanoma had lower median overall survival. ClinicalTrials.gov ID: : NCT02156804.

Original languageEnglish
Pages (from-to)168-178
Number of pages11
JournalEuropean Journal of Cancer
Volume119
DOIs
Publication statusPublished - Sep 1 2019

Keywords

  • Acral
  • Advanced melanoma
  • Ipilimumab
  • Mucosal
  • Nivolumab
  • Ocular

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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