New dosing schedules of Opdivo+Yervoy showed
encouraging efficacy with highest objective response rate for the
regimens observed using Opdivo 3 mg and Yervoy 1 mg (31%
to 39%)
Opdivo+Yervoy dosing schedules showed an acceptable tolerability
profile with 10% or fewer subjects discontinuing for grade 3-4 adverse
events
Clinical activity observed in both PD-L1 expressors and
non-expressors with greater activity in the PD-L1
expressors, representing approximately 70% of this
first-line patient population
Bristol-Myers
Squibb Company (NYSE:BMY) today announced updated
results from the Opdivo (nivolumab)+Yervoy (ipilimumab)
arms in CheckMate -012, a multi-arm Phase 1b trial evaluating Opdivo
in patients with chemotherapy-naïve advanced non-small cell lung cancer
(NSCLC). In this study, Opdivo was administered as monotherapy or
as part of a combination with other agents, including Yervoy, at
different doses and schedules. Results from other cohorts in CheckMate
-012 have been previously-unreported. These updated results include
findings from the administration of four new dosing schedules of Opdivo+Yervoy
(n=148), which resulted in confirmed objective response rates (ORR)
ranging from 13% to 39% depending on the administered regimen. Median
duration of response was not reached in any of these arms with a median
follow-up of 6.2 months to 16.6 months, and median progression-free
survival (PFS) ranged from 4.9 months to 10.6 months.
The types of treatment-related serious adverse events (SAEs) reported in
these cohorts for CheckMate -012 were consistent with other
previously-reported Opdivo+Yervoy cohorts of this trial. The new
dosing schedules in this study resulted in less toxicity than
previously-reported dosing schedules, and were characterized by low
frequency of treatment-related adverse events (AEs) leading to
discontinuation (3% to 10%) and no treatment-related deaths. These data
will be presented today at the 16th World Conference on Lung
Cancer (WCLC) (Abstract #786).
“Clinical results from Opdivo+Yervoy have already been
reported in previously untreated metastatic melanoma, showing the
potential of dual immune checkpoint blockade targeting both PD-1 and
CTLA-4,” said Naiyer Rizvi, M.D., director of Thoracic Oncology and
Immunotherapeutics for the Division of Hematology and Oncology at
Columbia University Medical Center. “The preliminary results from this
trial in advanced non-small cell lung cancer similarly push the envelope
of benefit with an immunotherapy combination strategy in the first-line
treatment of advanced non-small cell lung cancer which warrants further
studies.”
Non-small cell lung cancer accounts for approximately 85% of all lung
cancer cases. Five year survival rates vary globally depending on the
stage and type of lung cancer.
“The results we are reporting today for Opdivo+Yervoy in
non-small cell lung cancer are very promising as they further expand our
scientific rationale and clinical data for combining Immuno-Oncology
agents,” said Michael Giordano, senior vice president, head of
Development, Oncology. “Overall survival data for Opdivo in the
second-line treatment of squamous non-small cell lung cancer marked
great progress in Immuno-Oncology; yet an unmet need remains for
first-line treatments that offer durable, long-term survival and greater
tolerability. We are hopeful that as we continue to advance Phase 3
clinical research of Opdivo-based combinations in the first-line
setting that we will be able to offer lung cancer patients an option
that fills this unmet need.”
About CheckMate -012
CheckMate -012 is a multi-arm Phase 1b trial evaluating the safety and
tolerability of Opdivo in patients with chemotherapy-naïve
advanced NSCLC, as either a monotherapy or in combination with other
agents, including Yervoy, at different doses and schedules.
The results presented at WCLC include 148 squamous (SQ) and non-SQ
patients who received Opdivo+Yervoy at one of the following new
dosing schedules. Across the studied regimens and doses, Opdivo+Yervoy
showed confirmed ORR ranging from 13% to 39% while median PFS ranged
from 4.9 months to 10.6 months.
Efficacy and safety results from the new dosing schedules of Opdivo+Yervoy
evaluated in CheckMate -012 are below.
|
|
|
N1 + I1* Q3W (N = 31)
|
|
N1 Q2W + I1* Q6W (N = 40)
|
|
N3 Q2W + I1** Q12W (N = 38)
|
|
N3 Q2W + I1** Q6W (N = 39)
|
Confirmed ORR, % (95% CI)
|
|
|
13 (4, 30)
|
|
25 (13, 41)
|
|
39 (24, 57)
|
|
31 (17, 48)
|
Partial Response
|
|
|
13
|
|
25
|
|
39
|
|
31
|
Unconfirmed Partial Response
|
|
|
3
|
|
3
|
|
5
|
|
8
|
Unconfimed + Confirmed
|
|
|
16
|
|
28
|
|
44
|
|
39
|
PFS rate at 24 weeks, % (95% CI)
|
|
|
55 (36, 71)
|
|
NC
|
|
63 (44, 76)
|
|
NC
|
Median PFS, months (95% CI)
|
|
|
10.6 (2.1, 16.3)
|
|
4.9 (2.8)
|
|
8.0 (4.2)
|
|
8.3 (2.6)
|
Grade 3-4 Treatment-related AEs, %
|
|
|
29
|
|
35
|
|
29
|
|
28
|
Grade 3-4 treatment-related AEs leading
to discontinuation, %
|
|
|
10
|
|
8
|
|
3
|
|
10
|
* Nivolumab 1mg/kg+ ipilimumab 1mg/kg; ** Nivolumab 3mg/kg+
ipilimumab 1mg/kg
|
CheckMate -012 also evaluated the efficacy of Opdivo+Yervoy by
PD-L1 expression. Of 148 patients enrolled, 71% had tumor samples
evaluable for PD-L1 expression. Clinical activity was observed in both
PD-L1 expressors and non-expressors, with greater activity in PD-L1
expressors, representing approximately 70% of the studied population.
See table below for efficacy results per PD-L1 expression.
|
|
|
|
|
|
|
N1 + I1* Q3W (N = 31)
|
|
N1 Q2W + I1* Q6W (N = 40)
|
|
N3 Q2W + I1** Q12W (N = 38)
|
|
N3 Q2W + I1** Q6W (N = 39)
|
≥1% PD-L1 expression
|
ORR, % (n/N)
|
|
|
8 (1/12)
|
|
24 (5/21)
|
|
48 (10/21)
|
|
48 (11/23)
|
mPFS, wks
(95% CI)
|
|
|
11.5 (7.1, )
|
|
21.1
(11.4, )
|
|
34.6
(15.9, 35.3)
|
|
NR
(15.4, )
|
PFS rate at 24 wks, % (95% CI)
|
|
|
42
(15, 67)
|
|
40
(18, 61)
|
|
74
(48, 88)
|
|
65
(42, 81)
|
<1% PD-L1 expression
|
ORR, % (n/N)
|
|
|
15
(2/13)
|
|
14
(1/7)
|
|
22
(2/9)
|
|
0
(0/7)
|
mPFS, wks (95% CI)
|
|
|
34.0
(8.9, )
|
|
NR
(10.1, )
|
|
23.1
(4.0, )
|
|
10.3
(7.4, 12.7)
|
PFS rate at 24 wks, % (95% CI)
|
|
|
57
(25, 80)
|
|
NC
|
|
39
(9, 69)
|
|
0
|
* Nivolumab 1mg/kg+ ipilimumab 1mg/kg; ** Nivolumab 3mg/kg+
ipilimumab 1mg/kg
|
The safety profile of Opdivo+Yervoy in this trial was consistent
with previously-reported studies. There were low frequency of
treatment-related grade 3-4 AEs leading to discontinuation (3%–10%) and
no treatment-related deaths. Discontinuation rates were comparable to
the Opdivo monotherapy arm of this study.
Data from these dosing schedules, along with previously reported data
from CheckMate -012, informed the ongoing Phase 3 trial comparing Opdivo
or Opdivo+Yervoy versus platinum doublet chemotherapy in
chemotherapy-naïve patients with advanced NSCLC (CheckMate -227).
About Opdivo and Yervoy
Cancer cells may exploit “regulatory” pathways, such as checkpoint
pathways, to hide from the immune system and shield the tumor from
immune attack. Opdivo and Yervoy are both
monoclonal antibodies and immune checkpoint inhibitors that target
separate, distinct checkpoint pathways. Inhibition of these immune
checkpoint pathways is thought to result in enhanced T-cell function
greater than the effects of either antibody alone.
Bristol-Myers Squibb has a broad, global development program to study Opdivo in
multiple tumor types consisting of more than 50 trials – as monotherapy
or in combination with other therapies – in which more than 8,000
patients have been enrolled worldwide.
Opdivo became the first PD-1 immune checkpoint inhibitor to
receive regulatory approval anywhere in the world on July 4, 2014 when
Ono Pharmaceutical Co. announced that it received manufacturing and
marketing approval in Japan for the treatment of patients with
unresectable melanoma. In the U.S., the Food and Drug Administration
(FDA) granted its first approval for Opdivo for the
treatment of patients with unresectable or metastatic melanoma and
disease progression following Yervoy and, if BRAF V600
mutation positive, a BRAF inhibitor. On March 4, 2015, Opdivo received
its second FDA approval for the treatment of patients with metastatic
squamous (SQ) non-small cell lung cancer (NSCLC) with progression on or
after platinum-based chemotherapy. On July 20, the European Commission
approved Nivolumab BMS for the treatment of locally advanced or
metastatic SQ NSCLC after prior chemotherapy.
On March 25, 2011, the FDA approved Yervoy 3 mg/kg
monotherapy for patients with unresectable or metastatic melanoma. Yervoy is
now approved in more than 40 countries.
Indication and Important Safety Information for OPDIVO®
(nivolumab)
INDICATION
OPDIVO® (nivolumab) is indicated for the treatment of
patients with metastatic squamous non-small cell lung cancer (NSCLC)
with progression on or after platinum-based chemotherapy.
IMPORTANT SAFETY INFORMATION
Immune-Mediated Pneumonitis
-
Severe pneumonitis or interstitial lung disease, including fatal
cases, occurred with OPDIVO treatment. Across the clinical trial
experience in 691 patients with solid tumors, fatal immune-mediated
pneumonitis occurred in 0.7% (5/691) of patients receiving OPDIVO; no
cases occurred in Trial 3. In Trial 3, immune-mediated pneumonitis
occurred in 6% (7/117) of patients receiving OPDIVO including five
Grade 3 and two Grade 2 cases. Monitor patients for signs and symptoms
of pneumonitis. Administer corticosteroids for Grade 2 or greater
pneumonitis. Permanently discontinue OPDIVO for Grade 3 or 4 and
withhold OPDIVO until resolution for Grade 2.
Immune-Mediated Colitis
-
In Trial 3, diarrhea occurred in 21% (24/117) of patients receiving
OPDIVO. Grade 3 immune-mediated colitis occurred in 0.9% (1/117) of
patients. Monitor patients for immune-mediated colitis. Administer
corticosteroids for Grade 2 (of more than 5 days duration), 3, or 4
colitis. Withhold OPDIVO for Grade 2 or 3. Permanently discontinue
OPDIVO for Grade 4 colitis or recurrent colitis upon restarting OPDIVO.
Immune-Mediated Hepatitis
-
In Trial 3, the incidences of increased liver test values were AST
(16%), alkaline phosphatase (14%), ALT (12%), and total bilirubin
(2.7%). Monitor patients for abnormal liver tests prior to and
periodically during treatment. Administer corticosteroids for Grade 2
or greater transaminase elevations. Withhold OPDIVO for Grade 2 and
permanently discontinue OPDIVO for Grade 3 or 4 immune-mediated
hepatitis.
Immune-Mediated Nephritis and Renal Dysfunction
-
In Trial 3, the incidence of elevated creatinine was 22%.
Immune-mediated renal dysfunction (Grade 2) occurred in 0.9% (1/117)
of patients. Monitor patients for elevated serum creatinine prior to
and periodically during treatment. For Grade 2 or 3 serum creatinine
elevation, withhold OPDIVO and administer corticosteroids; if
worsening or no improvement occurs, permanently discontinue OPDIVO.
Administer corticosteroids for Grade 4 serum creatinine elevation and
permanently discontinue OPDIVO.
Immune-Mediated Hypothyroidism and Hyperthyroidism
-
In Trial 3, hypothyroidism occurred in 4.3% (5/117) of patients
receiving OPDIVO. Hyperthyroidism occurred in 1.7% (2/117) of patients
including one Grade 2 case. Monitor thyroid function prior to and
periodically during treatment. Administer hormone replacement therapy
for hypothyroidism. Initiate medical management for control of
hyperthyroidism.
Other Immune-Mediated Adverse Reactions
-
The following clinically significant immune-mediated adverse reactions
occurred in <2% of OPDIVO-treated patients: adrenal insufficiency,
uveitis, pancreatitis, facial and abducens nerve paresis,
demyeliniation, autoimmune neuropathy, motor dysfunction and
vasculitis. Across clinical trials of OPDIVO administered at doses 3
mg/kg and 10 mg/kg, additional clinically significant, immune-mediated
adverse reactions were identified: hypophysitis, diabetic
ketoacidosis, hypopituitarism, Guillain-Barré syndrome, and myasthenic
syndrome. Based on the severity of adverse reaction, withhold OPDIVO,
administer high-dose corticosteroids, and, if appropriate, initiate
hormone- replacement therapy.
Embryofetal Toxicity
-
Based on its mechanism of action, OPDIVO can cause fetal harm when
administered to a pregnant woman. Advise pregnant women of the
potential risk to a fetus. Advise females of reproductive potential to
use effective contraception during treatment with OPDIVO and for at
least 5 months after the last dose of OPDIVO.
Lactation
-
It is not known whether OPDIVO is present in human milk. Because many
drugs, including antibodies, are excreted in human milk and because of
the potential for serious adverse reactions in nursing infants from
OPDIVO, advise women to discontinue breastfeeding during treatment.
Serious Adverse Reactions
-
In Trial 3, serious adverse reactions occurred in 59% of patients
receiving OPDIVO. The most frequent serious adverse drug reactions
reported in ≥2% of patients were dyspnea, pneumonia, chronic
obstructive pulmonary disease exacerbation, pneumonitis,
hypercalcemia, pleural effusion, hemoptysis, and pain.
Common Adverse Reactions
-
The most common adverse reactions (≥20%) reported with OPDIVO in Trial
3 were fatigue (50%), dyspnea (38%), musculoskeletal pain (36%),
decreased appetite (35%), cough (32%), nausea (29%), and constipation
(24%).
Please see U.S. Full Prescribing Information for OPDIVO at www.bms.com.
YERVOY Important Safety Information
WARNING: IMMUNE-MEDIATED ADVERSE REACTIONS
YERVOY can result in severe and fatal immune-mediated adverse
reactions due to T-cell activation and proliferation. These
immune-mediated reactions may involve any organ system; however, the
most common severe immune-mediated adverse reactions are enterocolitis,
hepatitis, dermatitis (including toxic epidermal necrolysis),
neuropathy, and endocrinopathy. The majority of these immune-mediated
reactions initially manifested during treatment; however, a minority
occurred weeks to months after discontinuation of YERVOY.
Assess patients for signs and symptoms of enterocolitis, dermatitis,
neuropathy, and endocrinopathy and evaluate clinical chemistries
including liver function tests (LFTs) and thyroid function tests at
baseline and before each dose.
Permanently discontinue YERVOY and initiate systemic high-dose
corticosteroid therapy for severe immune-mediated reactions.
Recommended Dose Modifications
Withhold dose for any moderate immune-mediated adverse reactions or for
symptomatic endocrinopathy until return to baseline, improvement to mild
severity, or complete resolution, and patient is receiving <7.5 mg
prednisone or equivalent per day.
Permanently discontinue YERVOY for any of the following:
-
Persistent moderate adverse reactions or inability to reduce
corticosteroid dose to 7.5 mg prednisone or equivalent per day
-
Failure to complete full treatment course within 16 weeks from
administration of first dose
-
Severe or life-threatening adverse reactions, including any of the
following:
-
Colitis with abdominal pain, fever, ileus, or peritoneal signs;
increase in stool frequency (≥7 over baseline), stool
incontinence, need for intravenous hydration for >24 hours,
gastrointestinal hemorrhage, and gastrointestinal perforation
-
AST or ALT >5 × the upper limit of normal (ULN) or total bilirubin
>3 × the ULN
-
Stevens-Johnson syndrome, toxic epidermal necrolysis, or rash
complicated by full-thickness dermal ulceration or necrotic,
bullous, or hemorrhagic manifestations
-
Severe motor or sensory neuropathy, Guillain-Barré syndrome, or
myasthenia gravis
-
Severe immune-mediated reactions involving any organ system
-
Immune-mediated ocular disease which is unresponsive to topical
immunosuppressive therapy
Immune-mediated Enterocolitis:
-
In the pivotal Phase 3 study in YERVOY-treated patients, severe,
life-threatening, or fatal (diarrhea of ≥7 stools above baseline,
fever, ileus, peritoneal signs; Grade 3-5) immunemediated
enterocolitis occurred in 34 (7%) and moderate (diarrhea with up to 6
stools above baseline, abdominal pain, mucus or blood in stool; Grade
2) enterocolitis occurred in 28 (5%) patients
-
Across all YERVOY-treated patients (n=511), 5 (1%) developed
intestinal perforation, 4 (0.8%) died as a result of complications,
and 26 (5%) were hospitalized for severe enterocolitis
-
Infliximab was administered to 5 of 62 (8%) patients with moderate,
severe, or life-threatening immune-mediated enterocolitis following
inadequate response to corticosteroids
-
Monitor patients for signs and symptoms of enterocolitis (such as
diarrhea, abdominal pain, mucus or blood in stool, with or without
fever) and of bowel perforation (such as peritoneal signs and ileus).
In symptomatic patients, rule out infectious etiologies and consider
endoscopic evaluation for persistent or severe symptoms
-
Permanently discontinue YERVOY in patients with severe enterocolitis
and initiate systemic corticosteroids (1-2 mg/kg/day of prednisone or
equivalent). Upon improvement to ≤Grade 1, initiate corticosteroid
taper and continue over at least 1 month. In clinical trials, rapid
corticosteroid tapering resulted in recurrence or worsening symptoms
of enterocolitis in some patients
-
Withhold YERVOY for moderate enterocolitis; administer anti-diarrheal
treatment and, if persistent for >1 week, initiate systemic
corticosteroids (0.5 mg/kg/day prednisone or equivalent)
Immune-mediated Hepatitis:
-
In the pivotal Phase 3 study in YERVOY-treated patients, severe,
life-threatening, or fatal hepatotoxicity (AST or ALT elevations >5x
the ULN or total bilirubin elevations >3x the ULN; Grade 3–5) occurred
in 8 (2%) patients, with fatal hepatic failure in 0.2% and
hospitalization in 0.4%
-
13 (2.5%) additional YERVOY-treated patients experienced moderate
hepatotoxicity manifested by LFT abnormalities (AST or ALT elevations
>2.5x but ≤5x the ULN or total bilirubin elevation >1.5x but ≤3x the
ULN; Grade 2)
-
Monitor LFTs (hepatic transaminase and bilirubin levels) and assess
patients for signs and symptoms of hepatotoxicity before each dose of
YERVOY. In patients with hepatotoxicity, rule out infectious or
malignant causes and increase frequency of LFT monitoring until
resolution
-
Permanently discontinue YERVOY in patients with Grade 3-5
hepatotoxicity and administer systemic corticosteroids (1-2 mg/kg/day
of prednisone or equivalent). When LFTs show sustained improvement or
return to baseline, initiate corticosteroid tapering and continue over
1 month. Across the clinical development program for YERVOY,
mycophenolate treatment has been administered in patients with
persistent severe hepatitis despite high-dose corticosteroids
-
Withhold YERVOY in patients with Grade 2 hepatotoxicity
-
In a dose-finding trial, Grade 3 increases in transaminases with or
without concomitant increases in total bilirubin occurred in 6 of 10
patients who received concurrent YERVOY (3 mg/kg) and vemurafenib (960
mg BID or 720 mg BID)
Immune-mediated Dermatitis:
-
In the pivotal Phase 3 study in YERVOY-treated patients, severe,
life-threatening, or fatal immune-mediated dermatitis (e.g.,
Stevens-Johnson syndrome, toxic epidermal necrolysis, or rash
complicated by full thickness dermal ulceration, or necrotic, bullous,
or hemorrhagic manifestations; Grade 3–5) occurred in 13 (2.5%)
patients
-
1 (0.2%) patient died as a result of toxic epidermal necrolysis
-
1 additional patient required hospitalization for severe dermatitis
-
There were 63 (12%) YERVOY-treated patients with moderate (Grade 2)
dermatitis
-
Monitor patients for signs and symptoms of dermatitis such as rash and
pruritus. Unless an alternate etiology has been identified, signs or
symptoms of dermatitis should be considered immune-mediated
-
Permanently discontinue YERVOY in patients with severe,
life-threatening, or fatal immunemediated dermatitis (Grade 3-5).
Administer systemic corticosteroids (1-2 mg/kg/day of prednisone or
equivalent). When dermatitis is controlled, corticosteroid tapering
should occur over a period of at least 1 month. Withhold YERVOY in
patients with moderate to severe signs and symptoms
-
Treat mild to moderate dermatitis (e.g., localized rash and pruritus)
symptomatically. Administer topical or systemic corticosteroids if
there is no improvement within 1 week
Immune-mediated Neuropathies:
-
In the pivotal Phase 3 study in YERVOY-treated patients, 1 case of
fatal Guillain-Barré syndrome and 1 case of severe (Grade 3)
peripheral motor neuropathy were reported
-
Across the clinical development program of YERVOY, myasthenia gravis
and additional cases of Guillain-Barré syndrome have been reported
-
Monitor for symptoms of motor or sensory neuropathy such as unilateral
or bilateral weakness, sensory alterations, or paresthesia.
Permanently discontinue YERVOY in patients with severe neuropathy
(interfering with daily activities) such as Guillain-Barré–like
syndromes
-
Institute medical intervention as appropriate for management of severe
neuropathy. Consider initiation of systemic corticosteroids (1-2
mg/kg/day of prednisone or equivalent) for severe neuropathies.
Withhold YERVOY in patients with moderate neuropathy (not interfering
with daily activities)
Immune-mediated Endocrinopathies:
-
In the pivotal Phase 3 study in YERVOY- treated patients, severe to
life-threatening immunemediated endocrinopathies (requiring
hospitalization, urgent medical intervention, or interfering with
activities of daily living; Grade 3-4) occurred in 9 (1.8%) patients
-
All 9 patients had hypopituitarism, and some had additional
concomitant endocrinopathies such as adrenal insufficiency,
hypogonadism, and hypothyroidism
-
6 of the 9 patients were hospitalized for severe endocrinopathies
-
Moderate endocrinopathy (requiring hormone replacement or medical
intervention; Grade 2) occurred in 12 (2.3%) YERVOY-treated patients
and consisted of hypothyroidism, adrenal insufficiency,
hypopituitarism, and 1 case each of hyperthyroidism and Cushing’s
syndrome
-
Median time to onset of moderate to severe immune-mediated
endocrinopathy was 11 weeks and ranged up to 19.3 weeks after the
initiation of YERVOY
-
Monitor patients for clinical signs and symptoms of hypophysitis,
adrenal insufficiency (including adrenal crisis), and hyper- or
hypothyroidism
-
Patients may present with fatigue, headache, mental status
changes, abdominal pain, unusual bowel habits, and hypotension, or
nonspecific symptoms which may resemble other causes such as brain
metastasis or underlying disease. Unless an alternate etiology has
been identified, signs or symptoms should be considered
immune-mediated
-
Monitor thyroid function tests and clinical chemistries at the
start of treatment, before each dose, and as clinically indicated
based on symptoms. In a limited number of patients, hypophysitis
was diagnosed by imaging studies through enlargement of the
pituitary gland
-
Withhold YERVOY in symptomatic patients. Initiate systemic
corticosteroids (1-2 mg/kg/day of prednisone or equivalent) and
initiate appropriate hormone replacement therapy. Long-term hormone
replacement therapy may be necessary
Other Immune-mediated Adverse Reactions, Including Ocular
Manifestations:
-
In the pivotal Phase 3 study in YERVOY-treated patients, clinically
significant immunemediated adverse reactions seen in <1% were:
nephritis, pneumonitis, meningitis, pericarditis, uveitis, iritis, and
hemolytic anemia
-
Across the clinical development program for YERVOY, likely
immune-mediated adverse reactions also reported with <1% incidence
were: myocarditis, angiopathy, temporal arteritis, vasculitis,
polymyalgia rheumatica, conjunctivitis, blepharitis, episcleritis,
scleritis, leukocytoclastic vasculitis, erythema multiforme,
psoriasis, pancreatitis, arthritis, autoimmune thyroiditis,
sarcoidosis, neurosensory hypoacusis, autoimmune central neuropathy
(encephalitis), myositis, polymyositis, and ocular myositis
-
Permanently discontinue YERVOY for clinically significant or severe
immune-mediated adverse reactions. Initiate systemic corticosteroids
(1-2 mg/kg/day of prednisone or equivalent) for severe immune-mediated
adverse reactions
-
Administer corticosteroid eye drops for uveitis, iritis, or
episcleritis. Permanently discontinue YERVOY for immune-mediated
ocular disease unresponsive to local immunosuppressive therapy
Pregnancy & Nursing:
-
YERVOY is classified as pregnancy category C. There are no adequate
and well-controlled studies of YERVOY in pregnant women. Use YERVOY
during pregnancy only if the potential benefit justifies the potential
risk to the fetus
-
Human IgG1 is known to cross the placental barrier and YERVOY is an
IgG1; therefore, YERVOY has the potential to be transmitted from the
mother to the developing fetus
-
It is not known whether YERVOY is secreted in human milk. Because many
drugs are secreted in human milk and because of the potential for
serious adverse reactions in nursing infants from YERVOY, a decision
should be made whether to discontinue nursing or to discontinue YERVOY
Common Adverse Reactions:
-
The most common adverse reactions (≥5%) in patients who received
YERVOY at 3 mg/kg were fatigue (41%), diarrhea (32%), pruritus (31%),
rash (29%), and colitis (8%)
Please see Full Prescribing Information, including Boxed WARNING
regarding immune-mediated adverse reactions, available at www.bms.com.
Yervoy is a registered trademark of Bristol-Myers Squibb Company.
Immuno-Oncology at Bristol-Myers Squibb
Surgery, radiation, cytotoxic or targeted therapies have represented the
mainstay of cancer treatment over the last several decades, but
long-term survival and a positive quality of life have remained elusive
for many patients with advanced disease.
To address this unmet medical need, Bristol-Myers Squibb is leading
research in an innovative field of cancer research and treatment known
as Immuno-Oncology, which involves agents whose primary mechanism is to
work directly with the body’s immune system to fight cancer. The company
is exploring a variety of compounds and immunotherapeutic approaches for
patients with different types of cancer, including researching the
potential of combining Immuno-Oncology agents that target different
pathways in the treatment of cancer.
Bristol-Myers Squibb is committed to advancing the science of
Immuno-Oncology, with the goal of changing survival expectations and the
way patients live with cancer.
About the Bristol-Myers Squibb and Ono
Pharmaceutical Collaboration
In 2011, through a collaboration agreement with Ono Pharmaceutical Co.,
Bristol-Myers Squibb expanded its territorial rights to develop and
commercialize Opdivo globally except in Japan, South Korea
and Taiwan, where Ono had retained all rights to the compound at the
time. On July 23, 2014, Bristol-Myers Squibb and Ono Pharmaceutical
further expanded the companies’ strategic collaboration agreement to
jointly develop and commercialize multiple immunotherapies – as single
agents and combination regimens – for patients with cancer in Japan,
South Korea and Taiwan.
About Bristol-Myers Squibb
Bristol-Myers Squibb is a global biopharmaceutical company whose mission
is to discover, develop and deliver innovative medicines that help
patients prevail over serious diseases. For more information about
Bristol-Myers Squibb, visit www.bms.com,
or follow us on Twitter at http://twitter.com/bmsnews.
Bristol-Myers Squibb Forward-Looking Statement
This press release contains "forward-looking statements" as that term
is defined in the Private Securities Litigation Reform Act of 1995
regarding the research, development and commercialization of
pharmaceutical products. Such forward-looking statements are based on
current expectations and involve inherent risks and uncertainties,
including factors that could delay, divert or change any of them, and
could cause actual outcomes and results to differ materially from
current expectations. No forward-looking statement can be guaranteed.
Among other risks, there can be no guarantee that the combination
treatment of Opdivo and Yervoy will receive regulatory approval.
Forward-looking statements in this press release should be evaluated
together with the many uncertainties that affect Bristol-Myers Squibb's
business, particularly those identified in the cautionary factors
discussion in Bristol-Myers Squibb's Annual Report on Form 10-K for the
year ended December 31, 2014 in our Quarterly Reports on Form 10-Q and
our Current Reports on Form 8-K. Bristol-Myers Squibb undertakes no
obligation to publicly update any forward-looking statement, whether as
a result of new information, future events or otherwise.
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