Study of Nivolumab (BMS-936558) in Combination With Gemcitabine/Cisplatin, Pemetrexed/Cisplatin, Carboplatin/Paclitaxel, Bevacizumab Maintenance, Erlotinib, Ipilimumab or as Monotherapy in Subjects With Stage IIIB/IV Non-small Cell Lung Cancer (NSCLC) (CheckMate 012)

This study is ongoing, but not recruiting participants.
Sponsor:
Information provided by (Responsible Party):
Bristol-Myers Squibb
ClinicalTrials.gov Identifier:
NCT01454102
First received: September 16, 2011
Last updated: August 19, 2015
Last verified: July 2015
  Purpose

There is no formal research hypothesis to be statistically tested in this protocol.

  • The study is evaluating the safety and tolerability of Nivolumab (BMS-936558) when combined with three platinum-based doublet chemotherapy regimens (Cisplatin/Gemcitabine; Cisplatin/Pemetrexed; and Carboplatin/Paclitaxel) in subjects with NSCLC.
  • The study is evaluating the safety and tolerability of Nivolumab as maintenance therapy in combination with Bevacizumab/Avastin that will be given after at least 4 cycles of platinum doublet chemotherapy.
  • The study is evaluating the safety and tolerability of Nivolumab in combination with Erlotinib among epidermal growth factor receptor (EGFR) mutation positive non-squamous NSCLC subjects and as monotherapy in subjects with NSCLC.
  • The study is evaluating the safety and tolerability of Nivolumab in combination with Ipilimumab in subjects with squamous and non-squamous NSCLC.
  • The study is evaluating the safety and tolerability of Nivolumab as switch maintenance therapy in subjects with squamous and non-squamous NSCLC.
  • The study is evaluating the safety and tolerability of Nivolumab as monotherapy among subjects with untreated, asymptomatic brain metastases and no evidence of cerebral edema.

Condition Intervention Phase
Non-small Cell Lung Cancer
Biological: Nivolumab
Drug: Gemcitabine
Drug: Cisplatin
Drug: Pemetrexed
Drug: Paclitaxel
Drug: Carboplatin
Drug: Bevacizumab
Drug: Erlotinib
Biological: Ipilimumab
Phase 1

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Multi-arm Phase I Safety Study of Nivolumab in Combination With Gemcitabine/Cisplatin, Pemetrexed/Cisplatin, Carboplatin/Paclitaxel, Bevacizumab Maintenance, Erlotinib, Ipilimumab or as Monotherapy in Subjects With Stage IIIB/IV Non-small Cell Lung Cancer (NSCLC)

Resource links provided by NLM:


Further study details as provided by Bristol-Myers Squibb:

Primary Outcome Measures:
  • Safety and tolerability of Nivolumab in combination with chemotherapy measured by frequency of drug related adverse events [ Time Frame: Up to 100 days after the last dose of study drug (approximately 36 weeks) ] [ Designated as safety issue: Yes ]
  • Safety and tolerability of Nivolumab in combination with chemotherapy measured by frequency of serious adverse events [ Time Frame: Up to 100 days after the last dose of study drug (approximately 36 weeks) ] [ Designated as safety issue: Yes ]
  • Safety and tolerability of Nivolumab in combination with chemotherapy measured by frequency of clinical laboratory test by worst toxicity grade [ Time Frame: At screening (up to 28 days prior to first treatment) ] [ Designated as safety issue: Yes ]
  • Safety and tolerability of Nivolumab in combination with chemotherapy measured by frequency of clinical laboratory test by worst toxicity grade [ Time Frame: Cycle 1 Day 1 ] [ Designated as safety issue: Yes ]
  • Safety and tolerability of Nivolumab in combination with chemotherapy measured by frequency of clinical laboratory test by worst toxicity grade [ Time Frame: Cycle 1 Day 8 ] [ Designated as safety issue: Yes ]
  • Safety and tolerability of Nivolumab in combination with chemotherapy measured by frequency of clinical laboratory test by worst toxicity grade [ Time Frame: Cycle 1 Day 15 ] [ Designated as safety issue: Yes ]
  • Safety and tolerability of Nivolumab in combination with chemotherapy measured by frequency of clinical laboratory test by worst toxicity grade [ Time Frame: Cycle 2 Day 1 ] [ Designated as safety issue: Yes ]
  • Safety and tolerability of Nivolumab in combination with chemotherapy measured by frequency of clinical laboratory test by worst toxicity grade [ Time Frame: Cycle 3 Day 1 ] [ Designated as safety issue: Yes ]
  • Safety and tolerability of Nivolumab in combination with chemotherapy measured by frequency of clinical laboratory test by worst toxicity grade [ Time Frame: Cycle 4 Day 1 ] [ Designated as safety issue: Yes ]
  • Safety and tolerability of Nivolumab in combination with chemotherapy measured by frequency of clinical laboratory test by worst toxicity grade [ Time Frame: Day 1 of every cycle from Cycle 4 until progression (approximately 24 weeks) ] [ Designated as safety issue: Yes ]
  • Safety and tolerability of Nivolumab in combination with chemotherapy measured by frequency of clinical laboratory test by worst toxicity grade [ Time Frame: End of treatment (approximately 24 weeks) for subjects discontinued due to other reasons ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • ORR based on Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 of subjects treated in arms A, B, C and D [ Time Frame: At screening (up to 28 days prior to first treatment), C4D1 (Week 10), every 6 weeks until C8D1, and then every 3 months thereafter until progression (approximately 24 weeks) or end of treatment for subjects who continue treatment beyond progression ] [ Designated as safety issue: No ]

    C4D1=Cycle 4 Day 1

    C8D1=Cycle 8 Day 1

    Objective Response Rate (ORR) is defined as the proportion of all treated subjects whose best overall response is either a complete response (CR) or partial response (PR)


  • PFSR based on RECIST 1.1 of subjects treated in arms A, B, C and D [ Time Frame: At screening (up to 28 days prior to first treatment), C4D1 (Week 10), every 6 weeks until C8D1, and then every 3 months thereafter until progression (approximately 24 weeks) or end of treatment for subjects who continue treatment beyond progression ] [ Designated as safety issue: No ]
    Progression Free Survival Rate (PFSR) is defined as the probability a subject remaining progression-free and/or surviving to 24 weeks. The probability will be calculated by the product limit method (Kaplan-Meier method) which takes into account censored data

  • ORR based on RECIST 1.1 of subjects treated in arms E, F, K, L, M, O, P, Q, R, S [ Time Frame: At screening (up to 28 days prior to first treatment), C6D1 (Week 11), C9D1 (Week 17), C12D1 (Week 23) and then every 3 months thereafter until progression (approximately 24 weeks) ] [ Designated as safety issue: No ]
    ORR is defined as the proportion of all treated subjects whose best overall response is either a CR or PR

  • PFSR based on RECIST 1.1 of subjects treated in arms E, F, K, L, M, O, P, Q, R, S [ Time Frame: At screening (up to 28 days prior to first treatment), C6D1 (Week 11), C9D1 (Week 17), C12D1 (Week 23) and then every 3 months thereafter until progression (approximately 24 weeks) ] [ Designated as safety issue: No ]
    PFSR is defined as the probability a subject remaining progression-free and/or surviving to 24 weeks. The probability will be calculated by the product limit method (Kaplan-Meier method) which takes into account censored data

  • ORR based on RECIST 1.1 of subjects treated in arms G, H, I, J and N [ Time Frame: C4D1 (Week 10), C7D1 (Week 17), C10D1 (Week 23) and then every 3 months thereafter until disease progression (approximately 24 weeks) ] [ Designated as safety issue: No ]
    ORR is defined as the proportion of all treated subjects whose best overall response is either a CR or PR

  • PFSR based on RECIST 1.1 of subjects treated in arms G, H, I, J and N [ Time Frame: C4D1 (Week 10), C7D1 (Week 17), C10D1 (Week 23) and then every 3 months thereafter until disease progression (approximately 24 weeks) ] [ Designated as safety issue: No ]
    PFSR is defined as the probability a subject remaining progression-free and/or surviving to 24 weeks. The probability will be calculated by the product limit method (Kaplan-Meier method) which takes into account censored data


Estimated Enrollment: 412
Study Start Date: December 2011
Estimated Study Completion Date: December 2017
Estimated Primary Completion Date: November 2017 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Arm A: Nivolumab + Gemcitabine + Cisplatin

Nivolumab solution intravenously every 3 weeks until progressive disease (PD) or discontinuation due to toxicity. Administered prior to chemotherapy on Day 1 of each cycle

Gemcitabine solution intravenously on Day 1 and Day 8 of every cycle for 4 cycles

Cisplatin solution intravenously on Day 1 of each cycle for 4 cycles

Biological: Nivolumab
Other Name: BMS-936558
Drug: Gemcitabine Drug: Cisplatin
Experimental: Nivolumab + Pemetrexed + Cisplatin

Nivolumab solution intravenously every 3 weeks until PD or discontinuation due to toxicity. Administered prior to chemotherapy on Day 1 of each cycle

Pemetrexed solution intravenously on Day 1 of every cycle for 4 cycles

Cisplatin solution intravenously on Day 1 of each cycle for 4 cycles

Biological: Nivolumab
Other Name: BMS-936558
Drug: Cisplatin Drug: Pemetrexed
Experimental: Arm C: Nivolumab + Paclitaxel + Carboplatin

Nivolumab solution intravenously every 3 weeks until PD or discontinuation due to toxicity. Administered prior to chemotherapy on Day 1 of each cycle

Paclitaxel solution intravenously on Day 1 of every cycle for 4 cycles

Carboplatin area under curve (AUC) 6 solution intravenously on Day 1 of every cycle for 4 cycles

Biological: Nivolumab
Other Name: BMS-936558
Drug: Paclitaxel Drug: Carboplatin
Experimental: Arm D: Nivolumab + Bevacizumab maintenance

Nivolumab solution intravenously every 3 weeks until PD or discontinuation due to toxicity. Administered prior to chemotherapy on Day 1 of each cycle

Bevacizumab administered prior to intravenous infusion on Cycle 1 Day 1 followed by intravenous infusion every 3 weeks on Cycle 2 onwards and until PD or discontinuation due to toxicity

Biological: Nivolumab
Other Name: BMS-936558
Drug: Bevacizumab
Experimental: Arm E: Nivolumab + Erlotinib

Nivolumab solution intravenously every 2 weeks until PD or discontinuation due to toxicity. Administered prior to chemotherapy on Day 1 of each cycle

Erlotinib tablet by mouth daily until PD or discontinuation due to toxicity

Biological: Nivolumab
Other Name: BMS-936558
Drug: Erlotinib
Experimental: Arm F: Nivolumab
Nivolumab solution intravenously every 2 weeks until PD or discontinuation due to toxicity. Administered over 60 minutes
Biological: Nivolumab
Other Name: BMS-936558
Experimental: Arm G: Nivolumab + Ipilimumab

In Squamous histology subjects (NSCLC)

Nivolumab solution administered intravenously prior to Ipilimumab on Day 1 of each cycle. Combination regimen will be provided for 4 cycles

Ipilimumab solution administered intravenously on Day 1 of each cycle, for 4 cycles

Followed by Nivolumab administered until PD or discontinuation due to toxicity

Biological: Nivolumab
Other Name: BMS-936558
Biological: Ipilimumab
Experimental: Arm H: Nivolumab + Ipilimumab

In non-squamous histology subjects (NSCLC)

Nivolumab solution administered intravenously prior to Ipilimumab on Day 1 of each cycle. Combination regimen will be provided for 4 cycles

Ipilimumab solution administered intravenously on Day 1 of each cycle, for 4 cycles

Followed by Nivolumab administered every 2 weeks until PD or discontinuation due to toxicity

Biological: Nivolumab
Other Name: BMS-936558
Biological: Ipilimumab
Experimental: Arm I: Nivolumab + Ipilimumab

In squamous histology subjects (NSCLC)

Nivolumab solution administered intravenously prior to Ipilimumab on Day 1 of each cycle. Combination regimen will be provided for 4 cycles

Ipilimumab solution administered intravenously on Day 1 of each cycle, for 4 cycles

Followed by Nivolumab administered every 2 weeks until PD or discontinuation due to toxicity

Biological: Nivolumab
Other Name: BMS-936558
Biological: Ipilimumab
Experimental: Arm J: Nivolumab + Ipilimumab

In non-squamous histology subjects (NSCLC)

Nivolumab solution administered intravenously prior to Ipilimumab on Day 1 of each cycle. Combination regimen will be provided for 4 cycles

Ipilimumab solution administered intravenously on Day 1 of each cycle, for 4 cycles

Followed by Nivolumab administered every 2 weeks until PD or discontinuation due to toxicity

Biological: Nivolumab
Other Name: BMS-936558
Biological: Ipilimumab
Experimental: Arm K: Nivolumab

In squamous histology subjects (NSCLC)

Nivolumab solution intravenously every 2 weeks until PD or discontinuation due to toxicity. Administered as switch maintenance therapy. A cycle is 2 weeks

Biological: Nivolumab
Other Name: BMS-936558
Experimental: Arm L: Nivolumab

In non-squamous histology subjects (NSCLC)

Nivolumab solution intravenously every 2 weeks until PD or discontinuation due to toxicity. Administered over 60 minutes as switch maintenance therapy. A cycle is 2 weeks

Biological: Nivolumab
Other Name: BMS-936558
Experimental: Arm M: Nivolumab

NSCLC subjects with untreated, asymptomatic brain metastases and have no evidence of cerebral edema

Nivolumab solution intravenously every 2 weeks until PD or discontinuation due to toxicity. Administered for up to an hour as monotherapy. A cycle is 2 weeks

Biological: Nivolumab
Other Name: BMS-936558
Experimental: Arm N: Nivolumab + Ipilimumab

In subjects with any histology (NSCLC)

Nivolumab solution administered intravenously prior to Ipilimumab on Day 1 of each cycle. Combination regimen will be provided for 4 cycles

Ipilimumab solution administered intravenously on Day 1 of each cycle, for 4 cycles

Followed by Nivolumab administered every 2 weeks until PD or discontinuation due to toxicity

Biological: Nivolumab
Other Name: BMS-936558
Biological: Ipilimumab
Experimental: Arm O: Nivolumab + Ipilimumab

Nivolumab at specified dose/schedule until PD or discontinuation due to toxicity

Ipilimumab at specified dose/schedule until PD or discontinuation due to toxicity

Biological: Nivolumab
Other Name: BMS-936558
Biological: Ipilimumab
Experimental: Arm P: Nivolumab + Ipilimumab

Nivolumab at specified dose/schedule until PD or discontinuation due to toxicity

Ipilimumab at specified dose/schedule until PD or discontinuation due to toxicity

Biological: Nivolumab
Other Name: BMS-936558
Biological: Ipilimumab
Experimental: Arm Q: Nivolumab + Ipilimumab

Nivolumab at specified dose/schedule until PD or discontinuation due to toxicity

Ipilimumab at specified dose/schedule until PD or discontinuation due to toxicity

Biological: Nivolumab
Other Name: BMS-936558
Biological: Ipilimumab
Experimental: Arm R: Nivolumab + Ipilimumab

Nivolumab at specified dose/schedule until PD or discontinuation due to toxicity

Ipilimumab at specified dose/schedule until PD or discontinuation due to toxicity

Biological: Nivolumab
Other Name: BMS-936558
Biological: Ipilimumab
Experimental: Arm S: Nivolumab + Ipilimumab

Nivolumab at specified dose/schedule until PD or discontinuation due to toxicity

Ipilimumab at specified dose/schedule until PD or discontinuation due to toxicity

Biological: Nivolumab
Other Name: BMS-936558
Biological: Ipilimumab

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

For more information regarding BMS clinical trial participation, please visit www.BMSStudyConnect.com

Inclusion Criteria:

  • Newly diagnosed and confirmed Stage IIIB/IV NSCLC
  • Previously treated NSCLC with asymptomatic brain metastases (eligible for Arm M) See additional details below
  • Men and women aged ≥18 years
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 1
  • Subject must be chemotherapy naive (except Arm D, K, L and M). Prior use of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) is acceptable. For Arms D, K, and L, subjects must be non-progressors within 42 days after completion of first-line treatment with ≥4 cycles of Platinum Doublet chemotherapy with or without Bevacizumab. See below for Arm M
  • Either a formalin fixed tissue block or a minimum of 10 slides of tumor sample (archived or fresh) must be available for biomarker evaluation (a local pathologist must review for adequacy of sampling)
  • Life expectancy of at least 3 months
  • Prior radiotherapy must have been completed at least 2 weeks prior to study entry

For Arm M:

  • No more than 4 brain metastases
  • Each brain metastases ≤3 cm in size
  • No evidence of cerebral edema
  • Subjects must be free of neurologic symptoms related to metastatic brain lesions and must not have required or received systemic corticosteroids for ≥10 days prior to initiation of study treatment
  • At least 1 measurable target brain lesion >0.5 cm and no larger than 3 cm in diameter and/or 2 measurable brain target lesions >0.3 cm
  • No prior radiation therapy, surgery, or other local therapy for target brain lesions
  • Must have received at least one prior systemic anticancer therapy for NSCLC

Exclusion Criteria:

  • Subjects with symptomatic brain metastases, spinal cord compression, or intractable back pain due to a compressive or destructive mass
  • Subjects who require emergent use of systemic steroids, emergent surgery and/or radiotherapy
  • Any active or history of a known autoimmune disease
  • Subjects with previous malignancies (except non-melanoma skin cancers, in situ bladder cancer, gastric, or colon cancers or cervical cancers/dysplasia, or breast carcinoma in situ) are excluded unless a complete remission was achieved at least 2 years prior to study entry and no additional therapy is required or anticipated to be required during the study period
  • History of Grade ≥2 neuropathy
  • Subjects with interstitial lung disease that is symptomatic or may interfere with the detection or management of suspected drug-related pulmonary toxicity
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01454102

Locations
United States, California
Ucla
Santa Monica, California, United States, 90404
United States, Connecticut
Yale University
New Haven, Connecticut, United States, 06520
United States, Florida
H. Lee Moffitt Cancer Center & Research Institute
Tampa, Florida, United States, 33612
United States, Maryland
Johns Hopkins Sidney Kimmel Comprehensive Cancer Center
Baltimore, Maryland, United States, 21287
United States, New York
Memorial Sloan Kettering Cancer Center
New York, New York, United States, 10065
United States, North Carolina
Duke University Medical Center
Durham, North Carolina, United States, 27710
United States, Pennsylvania
Fox Chase Cancer Center
Philadelphia, Pennsylvania, United States, 19111
United States, Texas
University Of Texas Southwestern University Hospital
Sallas, Texas, United States, 75390
United States, Washington
Seattle Cancer Care Alliance
Seattle, Washington, United States, 98109
Canada, Ontario
Local Institution
Hamilton, Ontario, Canada, L8V 5C2
Local Institution
Toronto, Ontario, Canada, M5G 2M9
Canada, Quebec
Local Institution
Ottawa, Quebec, Canada, K1H 8L6
Sponsors and Collaborators
Bristol-Myers Squibb
Investigators
Study Director: Bristol-Myers Squibb Bristol-Myers Squibb
  More Information

Additional Information:
No publications provided

Responsible Party: Bristol-Myers Squibb
ClinicalTrials.gov Identifier: NCT01454102     History of Changes
Other Study ID Numbers: CA209-012
Study First Received: September 16, 2011
Last Updated: August 19, 2015
Health Authority: Canada: Health Canada
Canada: Ethics Review Committee
United States: Food and Drug Administration
United States: Institutional Review Board

Additional relevant MeSH terms:
Carcinoma, Non-Small-Cell Lung
Lung Neoplasms
Bronchial Neoplasms
Carcinoma, Bronchogenic
Lung Diseases
Neoplasms
Neoplasms by Site
Respiratory Tract Diseases
Respiratory Tract Neoplasms
Thoracic Neoplasms
Bevacizumab
Carboplatin
Cisplatin
Erlotinib
Gemcitabine
Paclitaxel
Pemetrexed
Angiogenesis Inhibitors
Angiogenesis Modulating Agents
Anti-Infective Agents
Antimetabolites
Antimetabolites, Antineoplastic
Antimitotic Agents
Antineoplastic Agents
Antineoplastic Agents, Phytogenic
Antiviral Agents
Enzyme Inhibitors
Folic Acid Antagonists
Growth Inhibitors
Growth Substances

ClinicalTrials.gov processed this record on August 30, 2015