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T. Tokudome



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    P2.11 - Poster Session 2 - NSCLC Novel Therapies (ID 209)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Medical Oncology
    • Presentations: 1
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      P2.11-040 - Phase 1 study of ipilimumab in combination with paclitaxel/carboplatin in patients with non-small cell lung cancer (ID 2775)

      09:30 - 09:30  |  Author(s): T. Tokudome

      • Abstract

      Background
      Ipilimumab is a fully human IgG1 monoclonal antibody which blocks cytotoxic T-lymphocyte antigen-4 (CTLA-4) and augments antitumor T-cell responses. In a global phase 2 study in subjects with non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC), ipilimumab administrated in a phased schedule in combination with paclitaxel/carboplatin, improved immune-related progression-free survival with an acceptable safety profile. A pronounced benefit was observed in squamous NSCLC. We conducted the phase 1 study of ipilimumab in combination with paclitaxel/carboplatin in Japanese patients with NSCLC.

      Methods
      Target population was Japanese subjects with stage IIIB without indication for definitive radiotherapy, stage IV, or recurrent NSCLC. Patients received ipilimumab 3 mg/kg or 10 mg/kg (starting at Cycle 3) in addition to paclitaxel 175 mg/m2 and carboplatin AUC=6 every 3 weeks for up to 6 cycles. Dose limiting toxicity (DLT) was evaluated during the first two cycles of ipilimumab administration (Cycle 3 and Cycle 4). The recommended dose (RD) was defined as the highest dose at which no more than 2 out of 6 ipilimumab-treated patients experienced a DLT.

      Results
      A total 15 patients were enrolled and 12 patients received ipilimumab (female/male=1/11, range of age =53-70, stage IIIB/IV/recurrent=0/9/3, squamous/non-squamous= 1/ 11, ipilimumab 3 mg/kg / 10 mg/kg=6/6). DLTs were observed in 2 out of 6 ipilimumab-treated patients in ipilimumab 3 mg/kg arm (febrile neutropenia, amylase increased / 1patient, thrombocytopenia / 1patient) and 1 out of 6 ipilimumab -treated patients in ipilimumab 10 mg/kg arm (entercolitis, total-bilirubin increased, lipase increased). Of 10 patients evaluable for tumor response based on RECIST criteria, partial response and stable disease were achieved in 6 and 4 patients, respectively.

      Conclusion
      For Japanese patients with NSCLC, the RD of ipilimumab in combination with chemotherapy was identified as 10 mg/kg and it demonstrated acceptable safety profile and potential efficacy. Two global Phase 3 studies are ongoing in subjects evaluating ipilimumab 10 mg/kg in combination with chemotherapy in advanced squamous NSCLC (with carboplatin/paclitaxel) and extensive stage SCLC (with etoposide/platinum).