The European Commission (EC) has approved nivolumab (opdivo) plus ipilimumab (yervoy) with two cycles of platinum-based chemotherapy for the first-line treatment of adult patients with metastatic non-small cell lung cancer (NSCLC) whose tumours have no sensitising epidermal growth factor receptor (EGFR) mutation or anaplastic lymphoma kinase (ALK) translocation.

The combination of nivolumab plus ipilimumab with two cycles of chemotherapy is the first dual immunotherapy-based treatment option approved for patients in the European Union (EU) with this disease.

The EC’s decision is based on results from the Phase 3 CheckMate -9LA trial, which met its primary endpoint of superior overall survival (OS), as well as secondary endpoints of progression-free survival (PFS) and overall response rate (ORR), for the combination of nivolumab plus ipilimumab, given concomitantly with two cycles of chemotherapy, versus chemotherapy alone.

An improvement in duration of response (DoR) was also observed.

The safety profile of nivolumab plus ipilimumab and two cycles of chemotherapy was reflective of the known safety profiles of the immunotherapy and chemotherapy components in first-line NSCLC.

“With a complex disease like metastatic non-small cell lung cancer, the availability of different treatment options is critical for patients, who have diverse needs and challenges,” said Martin Reck, M.D., Ph.D., CheckMate -9LA study investigator, Lung Clinic Grosshansdorf, German Center of Lung Research.

“In the CheckMate -9LA trial, combining nivolumab and ipilimumab with two cycles of chemotherapy resulted in clinically meaningful overall survival benefits, which were consistent across patients with non-small cell lung cancer, regardless of PD-L1 expression levels or tumour histologies.

Following today’s approval, clinicians in the EU will be able to offer patients a new option that may help achieve early disease control and improve survival.”

“The European Commission’s approval of nivolumab plus ipilimumab with two cycles of chemotherapy is an important milestone for patients with metastatic non-small cell lung cancer who face a difficult prognosis despite recent advances,” said Abderrahim Oukessou, M.D., vice president, thoracic cancers development lead, Bristol Myers Squibb.

“This innovative regimen is built on the only approved dual immunotherapy foundation.

The combination of nivolumab plus ipilimumab has previously demonstrated long-term survival outcomes across multiple cancer types, including melanoma and renal cell carcinoma.

We look forward to collaborating with a broad range of European stakeholders to bring this unique combination of two potentially synergistic immunotherapies with chemotherapy to eligible patients with lung cancer.”

This decision marks the third indication for an nivolumab plus ipilimumab-based regimen in the EU, following previous approvals in metastatic melanoma and advanced renal cell carcinoma (RCC).

In addition to the EU, the combination of nivolumab plus ipilimumab with two cycles of chemotherapy has been approved in 11 countries, including the U.S., for the first-line treatment of patients with metastatic NSCLC.

“Access to innovative medicines is key to improve outcomes for people impacted by lung cancer,” said Anne-Marie Baird, president of Lung Cancer Europe (LuCE).

“We are pleased to see new treatment options approved that may potentially help more people with metastatic non-small cell lung cancer.''

Source: BMS