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    Clinical Trial Results:
    An Open-label, Single-arm Phase II Safety Study of Nivolumab in Participants with Advanced or Metastatic Non-small Cell Lung Cancer Who Have Progressed During or After Receiving at Least One Prior Systemic Regimen

    Summary
    EudraCT number
    2016-003731-37
    Trial protocol
    RO  
    Global end of trial date
    14 Mar 2022

    Results information
    Results version number
    v1(current)
    This version publication date
    15 Dec 2022
    First version publication date
    15 Dec 2022
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    CA209-907
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    -
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Bristol-Myers Squibb
    Sponsor organisation address
    Chaussee de la Hulpe 185, Brussels, Belgium, 1170
    Public contact
    EU Study Start-Up Unit, Bristol-Myers Squibb International Corporation, Clinical.Trials@bms.com
    Scientific contact
    Bristol-Myers Squibb Study Director, Bristol-Myers Squibb, Clinical.Trials@bms.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    20 May 2022
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    14 Mar 2022
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The safety profile of less frequent dosing regimen of 480 mg of nivolumab every 4 weeks is expected to be similar to that of 3 mg/kg of nivolumab every 2 weeks in participants with advanced or metastatic NSCLC. The analyses to summarize incidence of treatment-related select adverse events will be descriptive.
    Protection of trial subjects
    The study was in compliance with the ethical principles derived from the Declaration of Helsinki and in compliance with all International Conference on Harmonization Good Clinical Practice Guidelines. All the local regulatory requirements pertinent to safety of trial participants were followed.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    16 Jan 2017
    Long term follow-up planned
    Yes
    Long term follow-up rationale
    Safety
    Long term follow-up duration
    1 Years
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Canada: 24
    Country: Number of subjects enrolled
    Japan: 20
    Country: Number of subjects enrolled
    Romania: 65
    Country: Number of subjects enrolled
    South Africa: 16
    Country: Number of subjects enrolled
    United States: 4
    Worldwide total number of subjects
    129
    EEA total number of subjects
    65
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    74
    From 65 to 84 years
    55
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    129 participants were treated

    Period 1
    Period 1 title
    Overall Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Non-randomised - controlled
    Blinding used
    Not blinded

    Arms
    Arm title
    Nivolumab 480mg Q4W
    Arm description
    480 mg of Nivolumab every 4 weeks (Q4W) until progression, unacceptable toxicity, withdrawal of consent, death, or a max of 2 years, whichever occurs first
    Arm type
    Experimental

    Investigational medicinal product name
    Nivolumab
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Intravenous use
    Dosage and administration details
    Nivolumab 480 mg every 4 weeks

    Number of subjects in period 1
    Nivolumab 480mg Q4W
    Started
    129
    Completed
    0
    Not completed
    129
         Disease progression
    98
         Study drug toxicity
    4
         Maximum clinical benefit
    2
         Adverse event unrelated to study drug
    7
         Other reasons
    1
         Completed treatment as per protocol
    17

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Nivolumab 480mg Q4W
    Reporting group description
    480 mg of Nivolumab every 4 weeks (Q4W) until progression, unacceptable toxicity, withdrawal of consent, death, or a max of 2 years, whichever occurs first

    Reporting group values
    Nivolumab 480mg Q4W Total
    Number of subjects
    129 129
    Age categorical
    Units: Subjects
        In utero
    0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0
        Newborns (0-27 days)
    0 0
        Infants and toddlers (28 days-23 months)
    0 0
        Children (2-11 years)
    0 0
        Adolescents (12-17 years)
    0 0
        Adults (18-64 years)
    74 74
        From 65-84 years
    55 55
        85 years and over
    0 0
    Age Continuous
    Units: Years
        arithmetic mean (standard deviation)
    61.8 ± 10.2 -
    Sex: Female, Male
    Units:
        Female
    34 34
        Male
    95 95
    Race (NIH/OMB)
    Units: Subjects
        American Indian or Alaska Native
    0 0
        Asian
    26 26
        Native Hawaiian or Other Pacific Islander
    0 0
        Black or African American
    3 3
        White
    95 95
        More than one race
    0 0
        Unknown or Not Reported
    5 5
    Ethnicity (NIH/OMB)
    Units: Subjects
        Hispanic or Latino
    1 1
        Not Hispanic or Latino
    41 41
        Unknown or Not Reported
    87 87

    End points

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    End points reporting groups
    Reporting group title
    Nivolumab 480mg Q4W
    Reporting group description
    480 mg of Nivolumab every 4 weeks (Q4W) until progression, unacceptable toxicity, withdrawal of consent, death, or a max of 2 years, whichever occurs first

    Primary: The number of participants experiencing high grade (Grades 3-4 and Grade 5) Drug-Related Select Adverse Events (AE)

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    End point title
    The number of participants experiencing high grade (Grades 3-4 and Grade 5) Drug-Related Select Adverse Events (AE) [1]
    End point description
    The number of participants who experienced at least 1 select AE of Grade 3-5, judged to be related to study drug per investigator with onset on or after first dose of study treatment and within 30 days of last dose of study treatment, divided by number of treated participants. AE grade is defined using National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) v4.0 criteria. The select AEs consist of pulmonary events, gastrointestinal events, hepatic events, renal events, skin events, endocrine events categories, thyroid disorders, diabetes, pituitary, adrenal disorder subcategories. Grade 3 is defined as severe or medically significant but not immediately life-threatening. Grade 4 is defined as life-threatening consequences and urgent intervention indicated. Grade 5 is defined as death related to AE.
    End point type
    Primary
    End point timeframe
    From the first dose of study treatment to up to 30 days of the last dose of study treatment (up to 24 months)
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: Summary statistics only were planned for this endpoint.
    End point values
    Nivolumab 480mg Q4W
    Number of subjects analysed
    129
    Units: Participants
        Total Participants with Grade 3-4 AE
    3
        Total Participants with Grade 5 AE
    0
    No statistical analyses for this end point

    Secondary: Progression Free Survival (PFS)

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    End point title
    Progression Free Survival (PFS)
    End point description
    Progression free survival (PFS) is defined as the time between the date of randomization and the date of the first documented tumor progression accounting for subsequent therapy, based on BICR (blinded independent central review) assessments (per RECIST v1.1 criteria), or death due to any cause, whichever occurs first. Participants will be censored at the last evaluable tumor assessment on or prior to the date of subsequent therapy. Progression is defined as at least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study). In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. (Note: the appearance of one or more new lesions is also considered progression).
    End point type
    Secondary
    End point timeframe
    From first dose to the date of the first documented tumor progression (up to approximately 5 months)
    End point values
    Nivolumab 480mg Q4W
    Number of subjects analysed
    129
    Units: Months
        median (confidence interval 95%)
    3.68 (3.06 to 4.50)
    No statistical analyses for this end point

    Secondary: Objective Response Rate (ORR)

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    End point title
    Objective Response Rate (ORR)
    End point description
    Objective Response Rate (ORR) defined as the percentage of participants with a best overall response (BOR) of confirmed complete response (CR) or partial response (PR) as assessed by investigator per RECIST 1.1. Complete response is defined as the disappearance of all target lesions and the reduction of any pathological lymph nodes to <10 mm. Partial response is defined as at least a 30% decrease in the sum of diameters of target lesions. Radiographic tumor assessments will be conducted at Week 8 (+/- 7 days) and every 8 weeks (+/- 7 days) until up to 2 years or until disease progression (or until discontinuation of study therapy in patients receiving nivolumab beyond progression), lost to follow-up, or withdrawal of study consent.
    End point type
    Secondary
    End point timeframe
    From the date of first dose to the date of the initial objectively documented tumor progression or the date of subsequent therapy, whichever occurs first (up to approximately 25 months).
    End point values
    Nivolumab 480mg Q4W
    Number of subjects analysed
    129
    Units: Percentage of participants
        number (confidence interval 95%)
    17.1 (11.0 to 24.7)
    No statistical analyses for this end point

    Secondary: Overall Survival (OS)

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    End point title
    Overall Survival (OS)
    End point description
    Overall Survival (OS) is defined as the time between the first dosing date and the date of death due to any cause. For participants without documentation of death, OS will be censored on the last date the participant was known to be alive.
    End point type
    Secondary
    End point timeframe
    From first dosing date and the date of death due to any cause (up to approximately 5 years)
    End point values
    Nivolumab 480mg Q4W
    Number of subjects analysed
    129
    Units: Months
        median (confidence interval 95%)
    10.58 (8.34 to 14.69)
    No statistical analyses for this end point

    Secondary: Duration of Response (DOR)

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    End point title
    Duration of Response (DOR)
    End point description
    Duration of Response (DOR) is defined as the time between the date of first confirmed response up to the date of the first documented tumor progression (per RECIST 1.1) as determined by complete response (CR) or partial response (PR), or death due to any cause, whichever occurs first. Participants who neither progress nor die will be censored on the date of their last evaluable tumor assessment. Participants who started any subsequent anti-cancer therapy (including palliative local therapy) without a prior reported progression will be censored at the last evaluable tumor assessment prior to or on the date of initiation of the subsequent anti-cancer therapy (including palliative local therapy). Complete response is defined as the disappearance of all target lesions and the reduction of any pathological lymph nodes to <10 mm. Partial response is defined as at least a 30% decrease in the sum of diameters of target lesions.
    End point type
    Secondary
    End point timeframe
    From the date of first confirmed response up to the date of the first documented tumor progression (per RECIST 1.1), or death due to any cause, whichever occurs first (up to approximately 48 months).
    End point values
    Nivolumab 480mg Q4W
    Number of subjects analysed
    22
    Units: Months
        median (confidence interval 95%)
    35.45 (10.87 to 47.31)
    No statistical analyses for this end point

    Post-hoc: The number of participants experiencing high grade (Grades 3-4 and Grade 5) Drug-Related Select Adverse Events (AE) - Extended Collection

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    End point title
    The number of participants experiencing high grade (Grades 3-4 and Grade 5) Drug-Related Select Adverse Events (AE) - Extended Collection
    End point description
    The number of participants who experienced at least 1 select AE of Grade 3-5, judged to be related to study drug per investigator with onset on or after first dose of study treatment and within 30 days of last dose of study treatment, divided by number of treated participants. AE grade is defined using National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) v4.0 criteria. The select AEs consist of pulmonary events, gastrointestinal events, hepatic events, renal events, skin events, endocrine events categories, thyroid disorders, diabetes, pituitary, adrenal disorder subcategories. Grade 3 is defined as severe or medically significant but not immediately life-threatening. Grade 4 is defined as life-threatening consequences and urgent intervention indicated. Grade 5 is defined as death related to AE. Note: This outcome measure represents an update to the primary endpoint to include additional data collection that occurred after the primary completion date.
    End point type
    Post-hoc
    End point timeframe
    From the first dose of study treatment to up to 30 days of the last dose of study treatment (up to 25 months)
    End point values
    Nivolumab 480mg Q4W
    Number of subjects analysed
    129
    Units: Participants
        Total Participants with Grade 3-4 AE
    6
        Total Participants with Grade 5 AE
    0
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Participants were assessed for all-cause mortality from their enrollment to study completion, (up to approximately 5 years). SAEs and NAEs were assessed from first dose to 100 days following last dose (up to approximately 27 months)
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    25.0
    Reporting groups
    Reporting group title
    Nivolumab 480mg Q4W
    Reporting group description
    480 mg of Nivolumab every 4 weeks (Q4W) until progression, unacceptable toxicity, withdrawal of consent, death, or a max of 2 years, whichever occurs first

    Serious adverse events
    Nivolumab 480mg Q4W
    Total subjects affected by serious adverse events
         subjects affected / exposed
    56 / 129 (43.41%)
         number of deaths (all causes)
    105
         number of deaths resulting from adverse events
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Lymphangiosis carcinomatosa
         subjects affected / exposed
    1 / 129 (0.78%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Malignant neoplasm progression
         subjects affected / exposed
    37 / 129 (28.68%)
         occurrences causally related to treatment / all
    0 / 37
         deaths causally related to treatment / all
    0 / 34
    Vascular disorders
    Deep vein thrombosis
         subjects affected / exposed
    1 / 129 (0.78%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Haemorrhage
         subjects affected / exposed
    1 / 129 (0.78%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    General disorders and administration site conditions
    Non-cardiac chest pain
         subjects affected / exposed
    1 / 129 (0.78%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    General physical health deterioration
         subjects affected / exposed
    1 / 129 (0.78%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Acute respiratory distress syndrome
         subjects affected / exposed
    1 / 129 (0.78%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Acute respiratory failure
         subjects affected / exposed
    1 / 129 (0.78%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Dyspnoea
         subjects affected / exposed
    1 / 129 (0.78%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pleural effusion
         subjects affected / exposed
    1 / 129 (0.78%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Pneumonitis
         subjects affected / exposed
    1 / 129 (0.78%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Pneumothorax
         subjects affected / exposed
    2 / 129 (1.55%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Pulmonary embolism
         subjects affected / exposed
    1 / 129 (0.78%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Investigations
    Influenza A virus test positive
         subjects affected / exposed
    1 / 129 (0.78%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Injury, poisoning and procedural complications
    Tendon rupture
         subjects affected / exposed
    1 / 129 (0.78%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Spinal compression fracture
         subjects affected / exposed
    1 / 129 (0.78%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Femoral neck fracture
         subjects affected / exposed
    1 / 129 (0.78%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cardiac disorders
    Cardiac tamponade
         subjects affected / exposed
    1 / 129 (0.78%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Nervous system disorders
    Amnesia
         subjects affected / exposed
    1 / 129 (0.78%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Blood and lymphatic system disorders
    Pancytopenia
         subjects affected / exposed
    1 / 129 (0.78%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Anaemia
         subjects affected / exposed
    1 / 129 (0.78%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Nausea
         subjects affected / exposed
    1 / 129 (0.78%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Colitis
         subjects affected / exposed
    1 / 129 (0.78%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Vomiting
         subjects affected / exposed
    1 / 129 (0.78%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Oesophageal ulcer
         subjects affected / exposed
    1 / 129 (0.78%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hepatobiliary disorders
    Cholecystitis acute
         subjects affected / exposed
    1 / 129 (0.78%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Cholecystitis chronic
         subjects affected / exposed
    1 / 129 (0.78%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Renal and urinary disorders
    Renal impairment
         subjects affected / exposed
    1 / 129 (0.78%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Nephrolithiasis
         subjects affected / exposed
    1 / 129 (0.78%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Acute kidney injury
         subjects affected / exposed
    1 / 129 (0.78%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Musculoskeletal and connective tissue disorders
    Bone pain
         subjects affected / exposed
    1 / 129 (0.78%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Empyema
         subjects affected / exposed
    1 / 129 (0.78%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Diverticulitis
         subjects affected / exposed
    1 / 129 (0.78%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastroenteritis
         subjects affected / exposed
    1 / 129 (0.78%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Influenza
         subjects affected / exposed
    1 / 129 (0.78%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Lower respiratory tract infection
         subjects affected / exposed
    1 / 129 (0.78%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Orchitis
         subjects affected / exposed
    1 / 129 (0.78%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pneumonia
         subjects affected / exposed
    6 / 129 (4.65%)
         occurrences causally related to treatment / all
    0 / 6
         deaths causally related to treatment / all
    0 / 0
    Pneumonia klebsiella
         subjects affected / exposed
    1 / 129 (0.78%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pneumonia aspiration
         subjects affected / exposed
    1 / 129 (0.78%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pulmonary tuberculosis
         subjects affected / exposed
    1 / 129 (0.78%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Sepsis
         subjects affected / exposed
    1 / 129 (0.78%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Urinary tract infection bacterial
         subjects affected / exposed
    1 / 129 (0.78%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Metabolism and nutrition disorders
    Hypomagnesaemia
         subjects affected / exposed
    1 / 129 (0.78%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hyperglycaemia
         subjects affected / exposed
    1 / 129 (0.78%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Nivolumab 480mg Q4W
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    111 / 129 (86.05%)
    Investigations
    Alanine aminotransferase increased
         subjects affected / exposed
    12 / 129 (9.30%)
         occurrences all number
    18
    Blood alkaline phosphatase increased
         subjects affected / exposed
    32 / 129 (24.81%)
         occurrences all number
    38
    Aspartate aminotransferase increased
         subjects affected / exposed
    11 / 129 (8.53%)
         occurrences all number
    12
    Blood creatinine increased
         subjects affected / exposed
    11 / 129 (8.53%)
         occurrences all number
    15
    Weight decreased
         subjects affected / exposed
    14 / 129 (10.85%)
         occurrences all number
    14
    Nervous system disorders
    Dizziness
         subjects affected / exposed
    7 / 129 (5.43%)
         occurrences all number
    7
    Headache
         subjects affected / exposed
    17 / 129 (13.18%)
         occurrences all number
    17
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    37 / 129 (28.68%)
         occurrences all number
    44
    General disorders and administration site conditions
    Oedema peripheral
         subjects affected / exposed
    8 / 129 (6.20%)
         occurrences all number
    8
    Non-cardiac chest pain
         subjects affected / exposed
    10 / 129 (7.75%)
         occurrences all number
    10
    Fatigue
         subjects affected / exposed
    19 / 129 (14.73%)
         occurrences all number
    20
    Asthenia
         subjects affected / exposed
    8 / 129 (6.20%)
         occurrences all number
    8
    Gastrointestinal disorders
    Diarrhoea
         subjects affected / exposed
    24 / 129 (18.60%)
         occurrences all number
    56
    Constipation
         subjects affected / exposed
    9 / 129 (6.98%)
         occurrences all number
    9
    Nausea
         subjects affected / exposed
    22 / 129 (17.05%)
         occurrences all number
    28
    Vomiting
         subjects affected / exposed
    12 / 129 (9.30%)
         occurrences all number
    14
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    16 / 129 (12.40%)
         occurrences all number
    19
    Dyspnoea
         subjects affected / exposed
    23 / 129 (17.83%)
         occurrences all number
    25
    Skin and subcutaneous tissue disorders
    Erythema
         subjects affected / exposed
    9 / 129 (6.98%)
         occurrences all number
    9
    Dry skin
         subjects affected / exposed
    7 / 129 (5.43%)
         occurrences all number
    8
    Rash
         subjects affected / exposed
    26 / 129 (20.16%)
         occurrences all number
    38
    Pruritus
         subjects affected / exposed
    24 / 129 (18.60%)
         occurrences all number
    35
    Psychiatric disorders
    Anxiety
         subjects affected / exposed
    7 / 129 (5.43%)
         occurrences all number
    7
    Endocrine disorders
    Hypothyroidism
         subjects affected / exposed
    8 / 129 (6.20%)
         occurrences all number
    8
    Hyperthyroidism
         subjects affected / exposed
    7 / 129 (5.43%)
         occurrences all number
    7
    Musculoskeletal and connective tissue disorders
    Back pain
         subjects affected / exposed
    10 / 129 (7.75%)
         occurrences all number
    12
    Infections and infestations
    Pneumonia
         subjects affected / exposed
    13 / 129 (10.08%)
         occurrences all number
    18
    Upper respiratory tract infection
         subjects affected / exposed
    7 / 129 (5.43%)
         occurrences all number
    12
    Metabolism and nutrition disorders
    Hypomagnesaemia
         subjects affected / exposed
    10 / 129 (7.75%)
         occurrences all number
    11
    Hypoalbuminaemia
         subjects affected / exposed
    15 / 129 (11.63%)
         occurrences all number
    18
    Hyperglycaemia
         subjects affected / exposed
    13 / 129 (10.08%)
         occurrences all number
    15
    Decreased appetite
         subjects affected / exposed
    21 / 129 (16.28%)
         occurrences all number
    23
    Hyponatraemia
         subjects affected / exposed
    14 / 129 (10.85%)
         occurrences all number
    17

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    26 Jan 2018
    Increased number of participants in study and sample size determination in statistical section; Updated biomarker section; Allowed participants with known PD-L1 result to receive treatment before submitting tissue; Added requirement of Additional Research for all US sites; Included additional language for nivolumab program level updates; Added the IND Number to Protocol Title Page; Updated information for Study Director and Medical Monitor
    10 Jul 2020
    Extended follow-up radiographic tumor assessment collection and survival follow-up to a maximum duration of 5 years after first dose; Updated to bring in line with current nivolumab and BMS protocol standards; Study personnel information updated.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
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