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Neoadjuvant Nivolumab, or Nivolumab in Combination With Ipilimumab, in Resectable NSCLC (NA_00092076)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT02259621
Recruitment Status : Active, not recruiting
First Posted : October 8, 2014
Results First Posted : March 20, 2024
Last Update Posted : March 20, 2024
Sponsor:
Collaborator:
Bristol-Myers Squibb
Information provided by (Responsible Party):
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins

Study Type Interventional
Study Design Allocation: Non-Randomized;   Intervention Model: Sequential Assignment;   Masking: None (Open Label);   Primary Purpose: Treatment
Condition Non-Small Cell Lung Cancer
Interventions Drug: Nivolumab
Drug: Carboplatin
Drug: Paclitaxel
Drug: Ipilimumab
Enrollment 39
Recruitment Details  
Pre-assignment Details There were a total of 39 patients enrolled to this study; 9 participants enrolled to arm A, 16 participants enrolled onto arm B and 14 to C.
Arm/Group Title Arm A- Nivolumab and Ipilimumab Arm B- Nivolumab Arm C- Nivolumab, Carboplatin, & Paclitaxel
Hide Arm/Group Description One dose of Nivolumab 3mg/kg IV & Ipilimumab 1mg/kg will be administered to enrolled patients on Day-42, then 2 doses of Nivolumab 3mg/kg will be administered to enrolled patients on Day-28 and Day-14

Nivolumab administration:

Three doses of nivolumab will be administered to enrolled patients on Day -42, Day -28, and Day-14 (+/- two days) prior to planned surgery on Day 0 or up to +10 days.

Nivolumab: Anti-PD-1 Therapy

Nivolumab 360 mg IV, Carboplatin AUC 5 or 6 IV, and Paclitaxel 175 or 200 mg/m2 IV every 21 days for 3 cycles prior to planned surgery on Day 0.

Nivolumab: Anti-PD-1 Therapy

Carboplatin: Anti-PD-1 Therapy

Paclitaxel: Anti-PD-1 Therapy

Period Title: Overall Study
Started 9 16 14
Completed 9 16 14
Not Completed 0 0 0
Arm/Group Title Arm A- Nivolumab and Ipilimumab Arm B- Nivolumab Arm C- Nivolumab, Carboplatin, & Paclitaxel Total
Hide Arm/Group Description One dose of Nivolumab 3mg/kg IV & Ipilimumab 1mg/kg will be administered to enrolled patients on Day-42, then 2 doses of Nivolumab 3mg/kg will be administered to enrolled patients on Day-28 and Day-14

Nivolumab administration:

Three doses of nivolumab will be administered to enrolled patients on Day -42, Day -28, and Day-14 (+/- two days) prior to planned surgery on Day 0 or up to +10 days.

Nivolumab: Anti-PD-1 Therapy

Nivolumab 360 mg IV, Carboplatin AUC 5 or 6 IV, and Paclitaxel 175 or 200 mg/m2 IV every 21 days for 3 cycles prior to planned surgery on Day 0.

Nivolumab: Anti-PD-1 Therapy

Carboplatin: Anti-PD-1 Therapy

Paclitaxel: Anti-PD-1 Therapy

Total of all reporting groups
Overall Number of Baseline Participants 9 16 14 39
Hide Baseline Analysis Population Description
[Not Specified]
Age, Categorical  
Measure Type: Count of Participants
Unit of measure:  Participants
Number Analyzed 9 participants 16 participants 14 participants 39 participants
<=18 years
0
   0.0%
0
   0.0%
0
   0.0%
0
   0.0%
Between 18 and 65 years
4
  44.4%
5
  31.3%
5
  35.7%
14
  35.9%
>=65 years
5
  55.6%
11
  68.8%
9
  64.3%
25
  64.1%
Age, Continuous  
Mean (Full Range)
Unit of measure:  Years
Number Analyzed 9 participants 16 participants 14 participants 39 participants
68
(53 to 84)
69
(52 to 81)
68
(46 to 78)
69
(46 to 81)
Sex: Female, Male  
Measure Type: Count of Participants
Unit of measure:  Participants
Number Analyzed 9 participants 16 participants 14 participants 39 participants
Female
2
  22.2%
7
  43.8%
8
  57.1%
17
  43.6%
Male
7
  77.8%
9
  56.3%
6
  42.9%
22
  56.4%
Race/Ethnicity, Customized  
Measure Type: Count of Participants
Unit of measure:  Participants
Race/Ethnicity Number Analyzed 9 participants 16 participants 14 participants 39 participants
White/Non-Hispanic
7
  77.8%
14
  87.5%
10
  71.4%
31
  79.5%
Black or African American/Unknown
0
   0.0%
1
   6.3%
0
   0.0%
1
   2.6%
White/Declined to answer
1
  11.1%
1
   6.3%
0
   0.0%
2
   5.1%
Unknown/Non-Hispanic
0
   0.0%
0
   0.0%
2
  14.3%
2
   5.1%
American Indian or Alaskan Native/Non-Hispanic
1
  11.1%
0
   0.0%
1
   7.1%
2
   5.1%
Other/Non-Hispanic
0
   0.0%
0
   0.0%
1
   7.1%
1
   2.6%
Region of Enrollment  
Measure Type: Count of Participants
Unit of measure:  Participants
Number Analyzed 9 participants 16 participants 14 participants 39 participants
Canada
0
   0.0%
2
  12.5%
11
  78.6%
13
  33.3%
United States
9
 100.0%
14
  87.5%
3
  21.4%
26
  66.7%
1.Primary Outcome
Title Safety as Measured by Number of Participants With Grade 3 and 4 Lab Abnormalities, as Defined by CTCAE v4.03
Hide Description Safety will be measured by drawing safety labs. (CBC and a Chemistry Panel will be drawn at 2 week intervals during Nivolumab administration). Grade 3 and 4 lab abnormalities will be recorded from both participating sites.
Time Frame 8 weeks
Hide Outcome Measure Data
Hide Analysis Population Description
[Not Specified]
Arm/Group Title Arm A- Nivolumab and Ipilimumab Arm B- Nivolumab Arm C- Nivolumab, Carboplatin, & Paclitaxel
Hide Arm/Group Description:
One dose of Nivolumab 3mg/kg IV & Ipilimumab 1mg/kg will be administered to enrolled patients on Day-42, then 2 doses of Nivolumab 3mg/kg will be administered to enrolled patients on Day-28 and Day-14

Nivolumab administration:

Three doses of nivolumab will be administered to enrolled patients on Day -42, Day -28, and Day-14 (+/- two days) prior to planned surgery on Day 0 or up to +10 days.

Nivolumab: Anti-PD-1 Therapy

Nivolumab 360 mg IV, Carboplatin AUC 5 or 6 IV, and Paclitaxel 175 or 200 mg/m2 IV every 21 days for 3 cycles prior to planned surgery on Day 0.

Nivolumab: Anti-PD-1 Therapy

Carboplatin: Anti-PD-1 Therapy

Paclitaxel: Anti-PD-1 Therapy

Overall Number of Participants Analyzed 9 16 14
Measure Type: Count of Participants
Unit of Measure: Participants
1
  11.1%
1
   6.3%
1
   7.1%
2.Primary Outcome
Title Safety as Assessed by Number of Grade 3 and 4 Adverse Events
Hide Description Number of Grade 3 and 4 adverse events as defined by CTCAE v4.03 that occur while a subject is participating in the study.
Time Frame 8 weeks
Hide Outcome Measure Data
Hide Analysis Population Description
[Not Specified]
Arm/Group Title Arm A- Nivolumab and Ipilimumab Arm B- Nivolumab Arm C- Nivolumab, Carboplatin, & Paclitaxel
Hide Arm/Group Description:
One dose of Nivolumab 3mg/kg IV & Ipilimumab 1mg/kg will be administered to enrolled patients on Day-42, then 2 doses of Nivolumab 3mg/kg will be administered to enrolled patients on Day-28 and Day-14

Nivolumab administration:

Three doses of nivolumab will be administered to enrolled patients on Day -42, Day -28, and Day-14 (+/- two days) prior to planned surgery on Day 0 or up to +10 days.

Nivolumab: Anti-PD-1 Therapy

Nivolumab 360 mg IV, Carboplatin AUC 5 or 6 IV, and Paclitaxel 175 or 200 mg/m2 IV every 21 days for 3 cycles prior to planned surgery on Day 0.

Nivolumab: Anti-PD-1 Therapy

Carboplatin: Anti-PD-1 Therapy

Paclitaxel: Anti-PD-1 Therapy

Overall Number of Participants Analyzed 9 16 14
Measure Type: Number
Unit of Measure: events
1 1 1
3.Secondary Outcome
Title Pathologic Response
Hide Description Pathologic response to neoadjuvant nivolumab, nivolumab plus ipilimumab, and nicvolumab, carboplatin, and paclitaxel in resected tumor and lymph nodes. The rate of major pathologic response, defined as <10% residual viable tumor cells in the resection specimen will be compared to historic data with neoadjuvant chemotherapy.
Time Frame 6 weeks
Outcome Measure Data Not Reported
4.Secondary Outcome
Title Radiographic Response
Hide Description Radiographic response to neoadjuvant nivolumab, nivolumab plus ipilimumab, and carboplatin and paclitaxel as defined by RECIST 1.1.
Time Frame 5 weeks
Outcome Measure Data Not Reported
Time Frame From the time of first dose of study medication up to 8 weeks.
Adverse Event Reporting Description [Not Specified]
 
Arm/Group Title Arm A- Nivolumab and Ipilimumab Arm B- Nivolumab Arm C- Nivolumab, Carboplatin, & Paclitaxel
Hide Arm/Group Description One dose of Nivolumab 3mg/kg IV & Ipilimumab 1mg/kg will be administered to enrolled patients on Day-42, then 2 doses of Nivolumab 3mg/kg will be administered to enrolled patients on Day-28 and Day-14

Nivolumab administration:

Three doses of nivolumab will be administered to enrolled patients on Day -42, Day -28, and Day-14 (+/- two days) prior to planned surgery on Day 0 or up to +10 days.

Nivolumab: Anti-PD-1 Therapy

Nivolumab 360 mg IV, Carboplatin AUC 5 or 6 IV, and Paclitaxel 175 or 200 mg/m2 IV every 21 days for 3 cycles prior to planned surgery on Day 0.

Nivolumab: Anti-PD-1 Therapy

Carboplatin: Anti-PD-1 Therapy

Paclitaxel: Anti-PD-1 Therapy

All-Cause Mortality
Arm A- Nivolumab and Ipilimumab Arm B- Nivolumab Arm C- Nivolumab, Carboplatin, & Paclitaxel
Affected / at Risk (%) Affected / at Risk (%) Affected / at Risk (%)
Total   1/9 (11.11%)      0/16 (0.00%)      0/14 (0.00%)    
Hide Serious Adverse Events
Arm A- Nivolumab and Ipilimumab Arm B- Nivolumab Arm C- Nivolumab, Carboplatin, & Paclitaxel
Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total   1/9 (11.11%)      4/16 (25.00%)      2/14 (14.29%)    
Cardiac disorders       
atrial fibrillation * 1  0/9 (0.00%)  0 1/16 (6.25%)  1 0/14 (0.00%)  0
General disorders       
infusion reaction * 1  0/9 (0.00%)  0 1/16 (6.25%)  1 0/14 (0.00%)  0
Infections and infestations       
lung infection * 1  0/9 (0.00%)  0 1/16 (6.25%)  1 0/14 (0.00%)  0
sepsis * 1  0/9 (0.00%)  0 1/16 (6.25%)  1 0/14 (0.00%)  0
Nervous system disorders       
posterior reversible encephalopathy syndrome * 1  0/9 (0.00%)  0 0/16 (0.00%)  0 1/14 (7.14%)  1
Respiratory, thoracic and mediastinal disorders       
pneumothorax * 1  0/9 (0.00%)  0 1/16 (6.25%)  1 0/14 (0.00%)  0
hypoxia * 1  0/9 (0.00%)  0 2/16 (12.50%)  2 0/14 (0.00%)  0
pneumonitis * 1  0/9 (0.00%)  0 1/16 (6.25%)  1 0/14 (0.00%)  0
pleural effusion * 1  0/9 (0.00%)  0 1/16 (6.25%)  1 0/14 (0.00%)  0
adult repiratory distress syndrome * 1  1/9 (11.11%)  1 0/16 (0.00%)  0 0/14 (0.00%)  0
Skin and subcutaneous tissue disorders       
subcutaneous emphysema * 1  0/9 (0.00%)  0 0/16 (0.00%)  0 1/14 (7.14%)  1
Vascular disorders       
hypotension * 1  0/9 (0.00%)  0 1/16 (6.25%)  1 0/14 (0.00%)  0
1
Term from vocabulary, CTCAE (4.0)
*
Indicates events were collected by non-systematic assessment
Hide Other (Not Including Serious) Adverse Events
Frequency Threshold for Reporting Other Adverse Events 0%
Arm A- Nivolumab and Ipilimumab Arm B- Nivolumab Arm C- Nivolumab, Carboplatin, & Paclitaxel
Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total   9/9 (100.00%)      15/16 (93.75%)      14/14 (100.00%)    
Blood and lymphatic system disorders       
anemia * 1  0/9 (0.00%)  0 4/16 (25.00%)  4 2/14 (14.29%)  2
blood and lymphatic system disorders - other * 1  0/9 (0.00%)  0 1/16 (6.25%)  1 0/14 (0.00%)  0
Cardiac disorders       
myocardial infarction * 1  0/9 (0.00%)  0 1/16 (6.25%)  1 0/14 (0.00%)  0
chest pain - cardiac * 1  1/9 (11.11%)  1 0/16 (0.00%)  0 1/14 (7.14%)  1
Ear and labyrinth disorders       
hearing impaired * 1  0/9 (0.00%)  0 1/16 (6.25%)  1 0/14 (0.00%)  0
Endocrine disorders       
hyperthyroidism * 1  1/9 (11.11%)  1 1/16 (6.25%)  1 0/14 (0.00%)  0
Eye disorders       
blurred vision * 1  0/9 (0.00%)  0 1/16 (6.25%)  1 0/14 (0.00%)  0
eye pain * 1  1/9 (11.11%)  1 0/16 (0.00%)  0 0/14 (0.00%)  0
floaters * 1  1/9 (11.11%)  1 0/16 (0.00%)  0 0/14 (0.00%)  0
Gastrointestinal disorders       
constipation * 1  1/9 (11.11%)  1 4/16 (25.00%)  4 8/14 (57.14%)  8
nausea * 1  2/9 (22.22%)  3 1/16 (6.25%)  1 6/14 (42.86%)  6
gastroesophageal reflux disease * 1  1/9 (11.11%)  1 3/16 (18.75%)  4 2/14 (14.29%)  3
diarrhea * 1  2/9 (22.22%)  2 1/16 (6.25%)  1 3/14 (21.43%)  3
mucositis oral * 1  0/9 (0.00%)  0 0/16 (0.00%)  0 2/14 (14.29%)  2
vomiting * 1  0/9 (0.00%)  0 0/16 (0.00%)  0 3/14 (21.43%)  3
abdominal pain * 1  1/9 (11.11%)  1 0/16 (0.00%)  0 0/14 (0.00%)  0
General disorders       
non-cardiac chest pain * 1  2/9 (22.22%)  2 6/16 (37.50%)  6 0/14 (0.00%)  0
irritability * 1  0/9 (0.00%)  0 1/16 (6.25%)  1 0/14 (0.00%)  0
fatigue * 1  5/9 (55.56%)  5 6/16 (37.50%)  6 6/14 (42.86%)  7
localized edema * 1  0/9 (0.00%)  0 1/16 (6.25%)  1 0/14 (0.00%)  0
infusion related reaction * 1  1/9 (11.11%)  1 1/16 (6.25%)  1 0/14 (0.00%)  0
edema limbs * 1  1/9 (11.11%)  1 0/16 (0.00%)  0 1/14 (7.14%)  1
chills * 1  1/9 (11.11%)  1 0/16 (0.00%)  0 2/14 (14.29%)  2
neck edema * 1  2/9 (22.22%)  2 0/16 (0.00%)  0 0/14 (0.00%)  0
Infections and infestations       
lip infection * 1  0/9 (0.00%)  0 1/16 (6.25%)  1 0/14 (0.00%)  0
skin infection * 1  0/9 (0.00%)  0 1/16 (6.25%)  1 0/14 (0.00%)  0
mucosal infection * 1  0/9 (0.00%)  0 1/16 (6.25%)  1 0/14 (0.00%)  0
urinary tract infection * 1  0/9 (0.00%)  0 0/16 (0.00%)  0 1/14 (7.14%)  1
tooth infection * 1  0/9 (0.00%)  0 0/16 (0.00%)  0 1/14 (7.14%)  1
lung infection * 1  1/9 (11.11%)  1 0/16 (0.00%)  0 0/14 (0.00%)  0
Injury, poisoning and procedural complications       
venous injury * 1  0/9 (0.00%)  0 1/16 (6.25%)  1 0/14 (0.00%)  0
postoperative thoracic procedure complication * 1  0/9 (0.00%)  0 0/16 (0.00%)  0 1/14 (7.14%)  1
Metabolism and nutrition disorders       
anorexia * 1  3/9 (33.33%)  4 2/16 (12.50%)  2 7/14 (50.00%)  8
hyponatremia * 1  0/9 (0.00%)  0 1/16 (6.25%)  1 0/14 (0.00%)  0
dehydration * 1  0/9 (0.00%)  0 1/16 (6.25%)  1 0/14 (0.00%)  0
hyperglycemia * 1  1/9 (11.11%)  1 1/16 (6.25%)  1 1/14 (7.14%)  1
Musculoskeletal and connective tissue disorders       
neck pain * 1  2/9 (22.22%)  2 1/16 (6.25%)  1 0/14 (0.00%)  0
back pain * 1  3/9 (33.33%)  3 2/16 (12.50%)  2 0/14 (0.00%)  0
arthralgia * 1  4/9 (44.44%)  4 4/16 (25.00%)  4 1/14 (7.14%)  1
chest wall pain * 1  0/9 (0.00%)  0 1/16 (6.25%)  1 0/14 (0.00%)  0
arthritis * 1  1/9 (11.11%)  2 0/16 (0.00%)  0 1/14 (7.14%)  1
pain in extremity * 1  2/9 (22.22%)  2 0/16 (0.00%)  0 4/14 (28.57%)  5
myalgia * 1  0/9 (0.00%)  0 0/16 (0.00%)  0 1/14 (7.14%)  1
bone pain * 1  1/9 (11.11%)  1 0/16 (0.00%)  0 0/14 (0.00%)  0
Nervous system disorders       
dizziness * 1  0/9 (0.00%)  0 3/16 (18.75%)  3 0/14 (0.00%)  0
seizure * 1  0/9 (0.00%)  0 1/16 (6.25%)  1 0/14 (0.00%)  0
headache * 1  2/9 (22.22%)  4 2/16 (12.50%)  2 1/14 (7.14%)  1
peripheral motor neuropathy * 1  0/9 (0.00%)  0 4/16 (25.00%)  4 2/14 (14.29%)  3
tremor * 1  0/9 (0.00%)  0 1/16 (6.25%)  1 0/14 (0.00%)  0
syncope * 1  0/9 (0.00%)  0 1/16 (6.25%)  1 0/14 (0.00%)  0
paresthesia * 1  0/9 (0.00%)  0 1/16 (6.25%)  1 4/14 (28.57%)  4
dysgeusia * 1  1/9 (11.11%)  1 0/16 (0.00%)  0 1/14 (7.14%)  1
recurrent laryngeal nerve palsy * 1  1/9 (11.11%)  1 0/16 (0.00%)  0 0/14 (0.00%)  0
Psychiatric disorders       
anxiety * 1  3/9 (33.33%)  3 4/16 (25.00%)  4 1/14 (7.14%)  1
depression * 1  2/9 (22.22%)  2 1/16 (6.25%)  1 0/14 (0.00%)  0
insomnia * 1  1/9 (11.11%)  1 2/16 (12.50%)  2 0/14 (0.00%)  0
Renal and urinary disorders       
urinary urgency * 1  0/9 (0.00%)  0 0/16 (0.00%)  0 1/14 (7.14%)  1
Reproductive system and breast disorders       
breast pain * 1  0/9 (0.00%)  0 1/16 (6.25%)  1 0/14 (0.00%)  0
Respiratory, thoracic and mediastinal disorders       
dyspnea * 1  5/9 (55.56%)  5 5/16 (31.25%)  6 6/14 (42.86%)  6
cough * 1  4/9 (44.44%)  4 6/16 (37.50%)  6 1/14 (7.14%)  1
wheezing * 1  2/9 (22.22%)  2 2/16 (12.50%)  2 0/14 (0.00%)  0
productive cough * 1  2/9 (22.22%)  2 2/16 (12.50%)  2 0/14 (0.00%)  0
bronchial obstruction * 1  0/9 (0.00%)  0 1/16 (6.25%)  1 0/14 (0.00%)  0
hoarseness * 1  1/9 (11.11%)  1 1/16 (6.25%)  1 1/14 (7.14%)  1
pneumothorax * 1  2/9 (22.22%)  2 3/16 (18.75%)  3 0/14 (0.00%)  0
dry cough * 1  0/9 (0.00%)  0 0/16 (0.00%)  0 1/14 (7.14%)  1
pneumonitis * 1  0/9 (0.00%)  0 0/16 (0.00%)  0 1/14 (7.14%)  1
epistaxis * 1  0/9 (0.00%)  0 0/16 (0.00%)  0 1/14 (7.14%)  1
sore throat * 1  1/9 (11.11%)  1 0/16 (0.00%)  0 1/14 (7.14%)  1
sleep apnea * 1  0/9 (0.00%)  0 0/16 (0.00%)  0 1/14 (7.14%)  1
hypoxia * 1  1/9 (11.11%)  2 0/16 (0.00%)  0 0/14 (0.00%)  0
pleural effusion * 1  1/9 (11.11%)  1 0/16 (0.00%)  0 0/14 (0.00%)  0
Skin and subcutaneous tissue disorders       
pruritis * 1  1/9 (11.11%)  2 2/16 (12.50%)  2 3/14 (21.43%)  3
rash maculo-papular * 1  2/9 (22.22%)  3 1/16 (6.25%)  1 5/14 (35.71%)  5
dry skin * 1  1/9 (11.11%)  1 3/16 (18.75%)  5 1/14 (7.14%)  3
alopecia * 1  0/9 (0.00%)  0 0/16 (0.00%)  0 8/14 (57.14%)  8
rash acneiform * 1  0/9 (0.00%)  0 0/16 (0.00%)  0 1/14 (7.14%)  1
photosensitivity * 1  1/9 (11.11%)  1 0/16 (0.00%)  0 0/14 (0.00%)  0
Surgical and medical procedures       
surgical and medical procedures - other * 1  1/9 (11.11%)  1 0/16 (0.00%)  0 3/14 (21.43%)  3
Vascular disorders       
hypertension * 1  0/9 (0.00%)  0 2/16 (12.50%)  2 0/14 (0.00%)  0
1
Term from vocabulary, CTCAE (4.0)
*
Indicates events were collected by non-systematic assessment
Certain Agreements
Principal Investigators are NOT employed by the organization sponsoring the study.
There is NOT an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.
Results Point of Contact
Layout table for Results Point of Contact information
Name/Title: Jasmine Brooks
Organization: Johns Hopkins SKCCC Clinical Research Office Coordinating Center
Phone: 6673068335
EMail: jbrook54@jhmi.edu
Publications:
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Layout table for additonal information
Responsible Party: Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
ClinicalTrials.gov Identifier: NCT02259621    
Other Study ID Numbers: J1414
NA_00092076 ( Other Identifier: JHMIRB )
First Submitted: September 18, 2014
First Posted: October 8, 2014
Results First Submitted: November 17, 2023
Results First Posted: March 20, 2024
Last Update Posted: March 20, 2024