NCI-MATCH Study: Next Phase for Nivolumab Beyond Colorectal Cancer
Posted: Friday, February 7, 2020
New research findings on nivolumab in mismatch repair (MMR)-deficient, relapsed or refractory noncolorectal cancers have emerged from NCI-MATCH, the largest-ever trial of personalized therapy based on molecular biomarkers. As reported in the Journal of Clinical Oncology, the anti–PD-1 immune checkpoint inhibitor nivolumab had efficacy in this phase II trial comparable with that of single-agent pembrolizumab in heavily pretreated patients with MMR-deficient prostate, endometrial, uterine, and other cancers. Adverse effects were generally low grade, reported Nilofer S. Azad, MD, of Johns Hopkins University, Baltimore, and co-investigators.
“The confirmed overall response rate for nivolumab in tumors with DNA mismatch repair deficiencies was 36%—or 15 of 42 patients with cancers other than colon,” said Dr. Azad in an ECOG-ACRIN Cancer Research Group press release. “An additional 21%–or five patients–had stable disease.”
The 42 evaluable patients with 19 different types of MMR-deficient cancers came from an initial pool of 4,902 screened candidates. The median overall survival with intravenous nivolumab treatment was 17.3 months. Overall response, the trial’s primary endpoint, was 36%, “which compares well with the previously reported 31% response rate for nivolumab in MMR-deficient colorectal cancer,” noted the authors. An additional 21% of patients had stable disease.
“Our initial report…with shorter follow-up showed a lower response rate for nivolumab (24%) compared with historical data with pembrolizumab, [but that] gap…has now closed with the longer…follow-up of 17.3 months,” pointed out Dr. Azad and colleagues. “These data support the premise that responses to immune therapy continue to occur over time, and patients with stable disease may eventually achieve a clinical partial response or complete response with continued therapy.”
The patients participated in the Z1D arm of NCI-MATCH (National Cancer Institute–Molecular Analysis for Therapy Choice). Among the other MMR-deficient cancers treated were breast, pancreatic, esophageal, and cholangiocarcinoma.
Disclosure: For full disclosures of the study authors, visit ascopubs.org.
