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Adjuvant nivolumab in resected stage IIB/C melanoma: primary results from the randomized, phase 3 CheckMate 76K trial

John M. Kirkwood, Michele Del Vecchio, Jeffrey S. Weber, Christoph Höeller, Jean‐Jacques Grob, Peter Mohr, Carmen Loquai, Caroline Dutriaux, Vanna Chiarion‐Sileni, Jacek Mackiewicz, Piotr Rutkowski, Petr Arenberger, G. Quéreux, Tarek Meniawy, Paolo A. Ascierto, Alexander M. Menzies, Piyush Durani, Maurice Lobo, Federico Campigotto, Brian Gastman, Georgina V. Long

2023Nature Medicine210 citationsDOIOpen Access PDF

Abstract

Patients with resected stage IIB/C melanoma have high recurrence risk, similar to those with resected stage IIIA/B disease. The phase 3, double-blind CheckMate 76K trial assessed 790 patients with resected stage IIB/C melanoma randomized 2:1 (stratified by tumor category) to nivolumab 480 mg or placebo every 4 weeks for 12 months. The primary endpoint was investigator-assessed recurrence-free survival (RFS). Secondary endpoints included distant metastasis-free survival (DMFS) and safety. At 7.8 months of minimum follow-up, nivolumab significantly improved RFS versus placebo (hazard ratio (HR) = 0.42; 95% confidence interval (CI): 0.30-0.59; P < 0.0001), with 12-month RFS of 89.0% versus 79.4% and benefit observed across subgroups; DMFS was also improved (HR = 0.47; 95% CI: 0.30-0.72). Treatment-related grade 3/4 adverse events occurred in 10.3% (nivolumab) and 2.3% (placebo) of patients. One treatment-related death (0.2%) occurred with nivolumab. Nivolumab is an effective and generally well-tolerated adjuvant treatment in patients with resected stage IIB/C melanoma. ClinicalTrials.gov identifier: NCT04099251 .

Topics & Concepts

NivolumabMedicineHazard ratioInternal medicinePlaceboClinical endpointAdverse effectAdjuvantConfidence intervalMelanomaRandomized controlled trialStage (stratigraphy)GastroenterologyAdjuvant therapySurgeryOncologyCancerImmunotherapyPathologyCancer researchBiologyPaleontologyAlternative medicineCutaneous Melanoma Detection and ManagementCAR-T cell therapy researchCancer Immunotherapy and Biomarkers