FDA approves Opdivo® + Yervoy® for HCC patients previously treated with sorafenib

Bristal Myers Squibb announced that Opdivo (nivolumab) 1 mg/kg plus Yervoy (ipilimumab) 3 mg/kg (I.V. Injetions) was approved by the U.S. Food and Drug Administration (FDA) for the treatment of hepatocellular carcinoma (HCC) in patients who have been previously treated with sorafenib. Approval has been granted under accelerated approval based on overall response rate and duration of response seen in the Opdivo + Yervoy cohort of the Phase 1/2 CheckMate -040 trial. Continued approval for this indication may be contingent upon verification and description of clinical benefit in confirmatory trials.

As stated by Anthony B. El-Khoueiry, M.D., lead investigator and associate professor of clinical medicine and phase I program director at the Keck School of Medicine, University of Southern California (USC) and the USC Norris Comprehensive Cancer Center, HCC is an aggressive disease which needs different treatment approaches. The overall response rate observed in the Opdivo + Yervoy cohort of the CheckMate-040 trial underscores the potential of this dual immunotherapy as a possible treatment option for patients.

In the CheckMate-040 cohort of HCC patients previously treated with sorafenib, after a minimum follow up of 28 months, 33% (16/49; 95% CI: 20-48) of patients responded to treatment with Opdivo + Yervoy; 8% (4/49) had a complete response (CR) and 24% (12/49) had a partial response (PR). Duration of responses (DOR) ranged from 4.6 to 30.5+ months, with 88% lasting at least six months, 56% at least 12 months and 31% at least 24 months. Overall response rate (ORR) and DOR were assessed by Blinded Independent Central Review (BICR) using Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v1.1). ORR assessed by BICR using modified RECIST was 35% (17/49; 95% CI: 22-50), with a CR reported in 12% (6/49) of patients and a PR reported in 22% (11/49) of patients.

Opdivo is associated with the following Warnings and Precautions including immune-mediated: pneumonitis, colitis, hepatitis, endocrinopathies, nephritis and renal dysfunction, skin adverse reactions, encephalitis, other adverse reactions; infusion-related reactions; embryo-fetal toxicity; and increased mortality in patients with multiple myeloma when Opdivo is added to a thalidomide analogue and dexamethasone, which is not recommended outside of controlled clinical trials.
The incidence of liver cancer is rising in the United States, and HCC is the most common and aggressive form of the disease. The approval provides a new option for patients with HCC previously treated with sorafenib, giving the community more hope.

Opdivo + Yervoy is the only dual immunotherapy approved by the FDA in this setting. The therapy features a potentially synergistic mechanism of action that targets two different checkpoints (PD-1 and CTLA-4) and works in complementary ways.

The company recognizes that there is a critical need to provide patients with aggressive forms of cancer, like HCC, new treatment options that may offer clinically meaningful and ultimately durable responses, The announcement builds on their legacy in pioneering immunotherapy treatments and is an important step in commitment to transforming patients’ lives through science.

Opdivo + Yervoy was granted Breakthrough Therapy Designation for this indication and a Priority Review from the FDA.

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News Source: Bristol-Myers Squibb Website
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