The Opdivo/Yervoy immunotherapy combo from Bristol Myers Squibb has earned some skepticism over the years from researchers questioning the efficacy of CTLA-4 in fighting tumors. But in advanced mesothelioma, the combination is showing multi-year clinical benefit in a particularly dire patient population.
After a minimum of three years follow-up, the Opdivo-Yervoy combo continued to beat out chemotherapy in terms of extending the lives of patients with unresectable malignant mesothelioma as a first-line therapy, according to updated data from the CHECKMATE-743 study set to be presented Friday at the ESMO virtual conference.
Twenty-three percent of patients treated with the combo were alive at the three-year mark compared with 15% on chemo, Bristol Myers said. Meanwhile, Opdivo/Yervoy continued to show a reduction in risk of death with a median OS of 18.1 months compared with 14.1 months for chemo.
Meanwhile, the combo continued to show durable responses underscoring those OS results. At three years, 28% of responders previously treated with Opdivo-Yervoy but off therapy for one year remained in response compared with 0% on chemo. Overall, the combo posted a median duration of response of 11.6 months compared with 6.7 months for chemo and an objective response rate that was “comparable” to chemo — 39.6% to 44%, respectively.
“For patients with malignant pleural mesothelioma, the prognosis is generally poor, with a five-year survival rate of approximately 10%,” said Solange Peters, an oncologist at the Lausanne University Hospital in Switzerland, in a statement. “In this aggressive cancer that historically has had limited treatment options, we’ve now not only seen the potential for patients to live longer with (Opdivo) plus (Yervoy), but that this benefit is sustained at three years compared to treatment with chemotherapy. These results give us further proof of the durability of the outcomes achieved with this combination.”
The Opdivo/Yervoy combo is now approved in 14 regulatory zones for this indication, where it received an initial FDA approval in October. The immunotherapy regimen was the first new systemic therapy approved to treat unresectable malignant mesothelioma since 2004.
The follow-on data is the first look at Bristol Myers’ planned slate at this year’s ESMO, which starts on Friday. In addition to the CHECKMATE-743 data, the drugmaker is rolling out more survival data for the Opdivo-Yervoy combo in other indications and an update on investigational LAG-3 inhibitor relatlimab’s pivotal study. There’s also a planned late-breaker from the Opdivo-Yervoy combo in CHECKMATE-649 in first-line gastric cancer.
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