Safety and Antitumor Activity of Anti–PD-1 Antibody, Nivolumab, in Patients With Platinum-Resistant Ovarian Cancer

• DOI: 10.1200/jco.2015.62.3397
• Publication Date: 2015-09-09T02:29:51Z
• Authors: Junzo Hamanishi; Masaki Mandai; Takafumi Ikeda; Manabu Minami; Atsushi Kawaguchi; Toshinori Murayama; Masashi Kanai; Yukiko Mori; Shigemi Matsumoto; Shunsuke Chikuma; Noriomi Matsumura; Kaoru Abiko; Tsukasa Baba; Ken Yamaguchi; Akihiko Ueda; Yuko Hosoe; Satoshi Morita; Masayuki Yokode; Akira Shimizu; Tasuku Honjo; Ikuo Konishi
• Keywords: Ovarian Neoplasms; Antibodies, Monoclonal; Antineoplastic Agents; Middle Aged; Cystadenocarcinoma, Serous; Endometrial Neoplasms; 3. Good health; Cohort Studies; 03 medical and health sciences; Nivolumab; 0302 clinical medicine; Drug Resistance, Neoplasm; Lymphatic Metastasis; Humans; Female; Neoplasm Invasiveness; Neoplasm Recurrence, Local; Peritoneal Neoplasms; Adenocarcinoma, Clear Cell; Aged; Follow-Up Studies; Neoplasm Staging; Platinum

PurposeProgrammed death-1 (PD-1), a coinhibitory immune signal receptor expressed in T cells, binds to PD-1 ligand and regulates antitumor immunity. Nivolumab is an anti–PD-1 antibody that blocks PD-1 signaling. We assessed the safety and antitumor activity of nivolumab in patients with platinum-resistant ovarian cancer.Patients and MethodsTwenty patients with platinum-resistant ovarian cancer were treated with an intravenous infusion of nivolumab every 2 weeks at a dose of 1 or 3 mg/kg (constituting two 10-patient cohorts) from October 21, 2011. This phase II trial defined the primary end point as the best overall response. Patients received up to six cycles (four doses per cycle) of nivolumab treatment or received doses until disease progression occurred. Twenty nivolumab-treated patients were evaluated at the end of the trial on December 7, 2014.ResultsGrade 3 or 4 treatment-related adverse events occurred in eight (40%) of 20 patients. Two patients had severe adverse events. In the 20 patients in whom responses could be evaluated, the best overall response was 15%, which included two patients who had a durable complete response (in the 3-mg/kg cohort). The disease control rate in all 20 patients was 45%. The median progression-free survival time was 3.5 months (95% CI, 1.7 to 3.9 months), and the median overall survival time was 20.0 months (95% CI, 7.0 months to not reached) at study termination.ConclusionThis study, to our knowledge, is the first to explore the effects of nivolumab against ovarian cancer. The encouraging safety and clinical efficacy of nivolumab in patients with platinum-resistant ovarian cancer indicate the merit of additional large-scale investigations (UMIN Clinical Trials Registry UMIN000005714).