Adjuvant nivolumab versus placebo following radical surgery for high-risk muscle-invasive urothelial carcinoma: a subgroup analysis of Japanese patients enrolled in the phase 3 CheckMate 274 trial

Author:

Tomita Yoshihiko1ORCID,Kobayashi Ko2,Kimura Go3,Oya Mototsugu4,Uemura Hirotsugu5,Nishiyama Hiroyuki6,Galsky Matthew D7,Nasroulah Federico8,Collette Sandra8,Broughton Edward8,Ünsal-Kaçmaz Keziban8,Kamisuki Yukinori9,Bajorin Dean F10

Affiliation:

1. Department of Urology, Molecular Oncology, Niigata University Graduate School of Medical and Dental Sciences , Niigata, Japan

2. School of Medicine, Sapporo Medical University Department of Urology, , Sapporo, Japan

3. Nippon Medical School Hospital Department of Urology, , Tokyo, Japan

4. Keio University School of Medicine Department of Urology, , Tokyo, Japan

5. Kindai University Hospital, Faculty of Medicine Department of Urology, , Osaka, Japan

6. Faculty of Medicine, University of Tsukuba Department of Urology, , Ibaraki, Japan

7. Icahn School of Medicine at Mount Sinai , New York, NY, USA

8. Bristol-Myers Squibb , Princeton, NJ, USA

9. Ono Pharmaceutical Co., Ltd. , Osaka, Japan

10. Memorial Sloan Kettering Cancer Center , New York, NY, USA

Abstract

Abstract Background The phase 3 CheckMate 274 trial demonstrated superiority of adjuvant nivolumab over placebo after radical surgery in patients with high-risk muscle-invasive urothelial carcinoma. However, the efficacy and safety of adjuvant nivolumab in Japanese patients with muscle-invasive urothelial carcinoma have not been clarified. Methods Patients with muscle-invasive urothelial carcinoma were randomized to adjuvant nivolumab 240 mg or placebo (every 2 weeks via intravenous infusion) up to 120 days after radical surgery in CheckMate 274. Results Of 49 patients in the Japanese subgroup, 27 and 22 patients were randomized to nivolumab and placebo, respectively. Eleven and 8 patients, respectively, had tumor PD-L1 expression level of 1% or more. The median disease-free survival times in the nivolumab and placebo groups were 29.67 months (95% confidence interval 7.79–not reached) and 9.72 months (95% confidence interval 4.73–not reached), respectively (hazard ratio 0.77, 95% confidence interval 0.35–1.69). The corresponding values in patients with tumor PD-L1 expression level of 1% or more were 29.67 months (95% confidence interval 2.63–not reached) and 25.95 months (95% confidence interval 5.59–not reached) (hazard ratio 1.10, 95% confidence interval 0.31–3.92), respectively. Treatment-related adverse events of Grade 3–4 occurred in 25.9 and 13.6% of patients in the nivolumab and placebo groups, respectively. The most common treatment-related adverse events in the nivolumab group were lipase increased, amylase increased and diarrhea. The changes in quality of life scores from baseline over time were similar in both groups. Conclusions The efficacy and safety results in the Japanese subgroup were consistent with the overall population of CheckMate 274.

Funder

Ono Pharmaceutical Co., Ltd. and Bristol-Myers Squibb

Publisher

Oxford University Press (OUP)

Subject

Cancer Research,Radiology, Nuclear Medicine and imaging,Oncology,General Medicine

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