Ipilimumab

抗癌圈再传重大喜讯！根据百时美施贵宝（Bristol Myers Squibb）官网消息，2025年4月8日，美国食品药品监督管理局（FDA）批准了Opdivo®（nivolumab，纳武利尤单抗）联合Yervoy®（ipilimumab，伊匹木单抗），用于先前未接受过治疗的不可切除或转移性微卫星不稳定性高（MSI-H）/错配修复缺陷（dMMR）结直肠癌（CRC）的一线治疗，适用范围覆盖成人及12岁以上儿童群体。这一消息，无疑为那些在病痛中苦苦挣扎的患者们注入了一剂强心针，带来了生的希望！ 此次获批比《处方药使用者付费法案》原定的2025年6月23日目标日期提前了超两个月。在此之前，FDA已授予该联合疗法突破性疗法认定及优先审查资格，大大加速了审批进程。这不仅体现了FDA对该疗法潜力的高度认可，更意味着全球范围内众多MSI-H/dMMR结直肠癌患者不必再漫长等待，能够更快地受益于这一创新治疗方案。 ▲截图源自“Bristol Myers Squibb” 一、半年双响！O+Y双免疗法从中国首发到美国FDA认可，改写MSI-H结直肠癌一线治疗 结直肠癌是全球发病率仅次于肺癌的恶性肿瘤。其中，约5%~15%的患者因DNA错配修复（dMMR）缺陷，呈现高微卫星不稳定性（MSI-H）特征。这类患者对传统化疗耐药性强、预后不佳，却对免疫检查点抑制剂（ICIs）治疗高度敏感。 突破性进展于2024年10月14日落地，中国国家药监局（NMPA）率先批准“O+Y双免疫治疗方案”——即Opdivo®（纳武利尤单抗，nivolumab，NIVO）联合Yervoy®（伊匹木单抗，ipilimumab，IPI）用于不可切除或转移性MSI-H/dMMR结直肠癌的一线治疗。这是该适应症在全世界范围内的首次获批，更让中国患者率先受益于创新疗法！ 时隔半年，美国FDA正式批准同款O+Y双免疫方案，同样用于结直肠癌的治疗。至此，该疗法成功斩获中美“双重认证”，标志着MSI-H/dMMR结直肠癌的免疫治疗迈入全球协同推进的新阶段，为更多患者点亮生命曙光！ 二、O+Y双免疫治疗方案3期数据爆表，结直肠癌进展或死亡风险直降79% O+Y双免疫治疗方案（即纳武利尤单抗+伊匹木单抗联合治疗）本次获美国FDA批准，主要基于一项3期CheckMate-8HW临床试验（NCT04008030）的突破性数据，该成果已在2024年ASCO大会发布。 本次研究共纳入303例MSI-H/dMMR表型的转移性结直肠癌（mCRC）患者，将其分为两组，即单药组（n=101，纳武利尤单抗单药治疗）、联合治疗组（n=202，纳武利尤单抗+伊匹木单抗联合治疗），中位随访时间为24.3个月。 结果显示：NIVO+IPI联合治疗，将疾病进展或死亡风险降低了79%[HR0.21（95%CI0.14–0.32）；P <0.0001]，详见下表。 ▲数据源自“ASCO”，版权归原作者所有，如无意中侵犯了知识产权，请联系我们删除 更值得一提的是，与单纯化疗相比，NIVO+IPI联合治疗具有临床意义和统计学意义的无进展生存期（PFS）改善（详见下图）。 ▲图源“ASCO”，版权归原作者所有，如无意中侵犯了知识产权，请联系我们删除 三、小编寄语 对于不可切除或转移性微卫星高度不稳定性（MSI-H）/ 错配修复缺陷（dMMR）结直肠癌患者，传统的化疗、放疗及靶向治疗往往收效甚微，多数患者仍面临预后不良的挑战。如今，纳武利尤单抗联合伊匹木单抗（O+Y 双免疫疗法）的获批，为这一困境带来破局希望！令人振奋的是，我国结直肠癌创新治疗领域持续突破，多款新药已获批上市，多项临床试验同步推进！ 四、参考资料 [1]Andre T,et al.Nivolumab (NIVO) plus ipilimumab (IPI) vs chemotherapy (chemo) as first-line (1L) treatment for microsatellite instability-high/mismatch repair-deficient (MSI-H/dMMR) metastatic colorectal cancer (mCRC): First results of the CheckMate 8HW study[J]. 2024. https://meetings.asco.org/abstracts-presentations/230735 [2]https://news.bms.com/news/corporate-financial/2025/U-S--Food-and-Drug-Administration-Approves-Opdivo-nivolumab-plus-Yervoy-ipilimumab-as-a-Treatment-for-Patients-with-Previously-Untreated-Microsatellite-Instability-High-or-Mismatch-Repair-Deficient-Unresectable-or-Metastatic-Colorectal-Cancer1/default.aspx 本文为全球肿瘤医生网原创，未经授权禁止转载。

Based on the Phase 3 CheckMate-8HW trial, Opdivo plus Yervoy demonstrated reduction in the risk of disease progression or death by 79% vs. chemotherapy in the first-line setting and by 38% vs. Opdivo monotherapy across all lines of therapy 1 The approval was granted more than two months ahead of the Prescription Drug User Fee Act goal date PRINCETON, NJ, USA I April 08, 2025 I Bristol Myers Squibb (NYSE: BMY) today announced that the U.S. Food and Drug Administration (FDA) approved Opdivo ® (nivolumab) plus Yervoy ® (ipilimumab) as a first-line treatment of adult and pediatric patients (12 years and older) with unresectable or metastatic microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR) colorectal cancer (CRC). 1 This approval is based on the CheckMate-8HW trial, which is the largest Phase 3 trial (n=839) of immunotherapy in patients with MSI-H/dMMR mCRC, evaluating Opdivo plus Yervoy (n=354) vs. Opdivo monotherapy (n=353) in the all-lines setting and Opdivo plus Yervoy (n=202) vs. investigator’s choice chemotherapy (n=101) (mFOLFOX-6 or FOLFIRI with or without bevacizumab or cetuximab) in the first-line setting. 1 Opdivo plus Yervoy met the dual primary endpoints of progression free survival (PFS) when compared to Opdivo monotherapy across all lines of therapy and when compared to chemotherapy in the first-line setting, as assessed by Blinded Independent Central Review (BICR). 1 This approval, granted more than two months ahead of the June 23, 2025 Prescription Drug User Fee Act goal date, follows the FDA’s prior decision to grant the application Breakthrough Therapy Designation and Priority Review status. “There is an unmet need for additional treatment options such as a dual immunotherapy approach for patients with previously untreated MSI-H/dMMR unresectable or metastatic CRC, which is an aggressive form of cancer and can be particularly difficult to treat,” said Heinz-Josef Lenz, MD, CheckMate-8HW investigator and Deputy Director for Research Programs and Head of the Gastrointestinal Cancers Program at the USC Norris Comprehensive Cancer Center. 2,3,4,5,6 “The meaningful outcomes in CheckMate-8HW underscore how initiating treatment with the dual immunotherapy combination of nivolumab plus ipilimumab may result in a notable survival benefit. 1,5 This approval has the potential to redefine traditional approaches of care for patients with this form of CRC.” In the CheckMate-8HW trial, Opdivo plus Yervoy demonstrated a 38% reduction in the risk of disease progression or death vs. Opdivo monotherapy in immunotherapy-naïve patients across all lines of therapy (Hazard Ratio [HR] 0.62; 95% Confidence Interval [CI] 0.48–0.81; P =0.0003). 1 Assessing the dual primary endpoint of PFS, the trial demonstrated that median PFS was not reached with Opdivo plus Yervoy (95% CI: 53.8-Not Estimable [NE]) and was 39.3 months with Opdivo monotherapy (95% CI: 22.1-NE). 1 PFS rates at 12-, 24-, and 36-months were also numerically higher compared to Opdivo monotherapy (76% vs. 63%, 71% vs. 56%, and 68% vs. 51%, respectively). 1 In Kaplan-Meier (KM) curves showing PFS rates with Opdivo plus Yervoy compared to Opdivo monotherapy, an early separation was observed at two months and sustained at three years. 1 Opdivo plus Yervoy also met a key secondary endpoint, demonstrating superior overall response rate (ORR) by BICR compared to Opdivo monotherapy (n=296, 71% vs. n=286, 58%; P =0.0011). 1 Of the most common all-cause adverse reactions (ARs) occurring in ≥10% of patients, similar rates of grade 3-4 ARs were observed between Opdivo plus Yervoy and Opdivo monotherapy. 1 The safety profile for the dual immunotherapy combination remained consistent with previously reported data and the ARs observed were manageable with established protocols, with no new safety signals identified. 1,5 Additional safety information can be found in the U.S. Full Prescribing Information for Opdivo . The Opdivo plus Yervoy vs. chemotherapy arm of the CheckMate-8HW trial showed that the combination regimen reduced the risk of cancer progression or death by 79% compared to chemotherapy in first-line patients (HR 0.21; 95% CI: 0.14-0.32; P <0.0001). 1 This arm also assessed the other dual primary endpoint of PFS, where median PFS was not reached with Opdivo plus Yervoy (95% CI: 38.4-NE) compared to 5.8 months with chemotherapy (95% CI: 4.4-7.8). PFS rates were numerically higher with Opdivo plus Yervoy vs. chemotherapy at 12- and 24-months (79% vs. 21% and 72% vs. 14%, respectively). 1 KM curves comparing PFS with Opdivo plus Yervoy vs. chemotherapy showed an early separation at three months, which was sustained through two years. 1 The regimen of Opdivo plus Yervoy represents the first-ever dual immune checkpoint inhibitor combination to demonstrate significant efficacy benefit compared to Opdivo monotherapy and chemotherapy in MSI-H/dMMR mCRC patients. 1,5 Opdivo and Yervoy are associated with the following Warnings and Precautions: severe and fatal immune-mediated adverse reactions including pneumonitis, colitis, hepatitis and hepatotoxicity, endocrinopathies, nephritis with renal dysfunction, dermatologic adverse reactions, other immune-mediated adverse reactions; infusion-related reactions; complications of allogeneic hematopoietic stem cell transplantation (HSCT); embryo-fetal toxicity; and increased mortality in patients with multiple myeloma when Opdivo is added to a thalidomide analogue and dexamethasone, which is not recommended outside of controlled clinical trials. 1 Please see the Important Safety Information section below. “This approval marks our ninth indication for an Opdivo -based treatment in the gastrointestinal space. 1 We are witnessing the transformative potential of dual immunotherapy in treating GI cancers,” said Wendy Short Bartie, senior vice president of Oncology Commercialization at Bristol Myers Squibb. 2,3,4,5 “People with MSI-H/dMMR metastatic colorectal cancer face high unmet need, and Opdivo plus Yervoy is an important new approach in the first-line setting. 2,3,4,5 This milestone can offer hope, and it underscores our commitment to continue reaching more patients with new treatment options.” 1 “Colorectal cancer is the third most commonly diagnosed cancer and the second most common cause of cancer-related death for men and women combined in the U.S., and concerning trends show that incidence is increasing in people younger than 50,” said Nicole Sheahan, President of the Global Colon Cancer Association. 6,7 “Despite the prevalence of CRC, there remains a high unmet need, highlighting the urgency for additional treatment options. 2,3,5,6,7 We are thrilled with this FDA approval as Opdivo plus Yervoy offers an exciting new first-line approach for patients with MSI-H/dMMR metastatic colorectal cancer.” 1 Opdivo as a single agent, or in combination with Yervoy , was previously granted accelerated approval in MSI-H/dMMR CRC adult and pediatric patients (12 years and older) that has progressed following treatment with a fluoropyrimidine, oxaliplatin, and irinotecan. 1 Today’s FDA decision converts this second-line indication to full approval for Opdivo monotherapy and expands the indication for Opdivo plus Yervoy into the first-line setting based on the CheckMate-8HW trial. 1 About CheckMate-8HW CheckMate-8HW is a Phase 3, randomized, multicenter, open-label trial evaluating Opdivo plus Yervoy compared to Opdivo alone or chemotherapy (mFOLFOX-6 or FOLFIRI with or without bevacizumab or cetuximab) in patients with unresectable MSI-H/dMMR mCRC. 8 In the CheckMate-8HW study, 839 patients were randomized to receive either Opdivo monotherapy ( Opdivo 240 mg Q2W for six doses, followed by Opdivo 480 mg Q4W), Opdivo plus Yervoy ( Opdivo 240 mg plus Yervoy 1 mg/kg Q3W for four doses, followed by Opdivo 480 mg Q4W), or investigator’s choice of chemotherapy. 8 The dual primary endpoints of the trial were PFS for Opdivo plus Yervoy compared to Opdivo alone across all lines of therapy and PFS for Opdivo plus Yervoy compared to chemotherapy in the first-line setting, as assessed by Blinded Independent Central Review (BICR). 8 The study is ongoing to assess various secondary endpoints, including overall survival (OS), and BMS will continue to work with the study investigators to present these data and longer-term follow-up in the future. 8 Select Safety Profile from CheckMate-8HW The safety analysis in CheckMate-8HW included 288 patients, of whom 200 received Opdivo plus Yervoy. 1 Serious adverse reactions occurred in 46% of patients receiving Opdivo plus Yervoy . 1 The most frequent serious adverse reactions reported in ≥1% of patients who received Opdivo plus Yervoy were adrenal insufficiency (2.8%), hypophysitis (2.8%), diarrhea (2.0%), abdominal pain (2.0%), small intestinal obstruction (2.0%), pneumonia (1.7%), acute kidney injury (1.4%), immune mediated enterocolitis (1.4%), pneumonitis (1.4%), colitis (1.1%), large intestinal obstruction (1.1%), and urinary tract infection (1.1%). 1 The most common adverse reactions reported in ≥ 20% of patients treated with Opdivo plus Yervoy were fatigue, diarrhea, pruritis, abdominal pain, musculoskeletal pain, and nausea. 1 Fatal adverse reactions occurred in 2 (0.6%) patients who received Opdivo plus Yervoy ; these included myocarditis and pneumonitis, 1 each. 1 Opdivo and/or Yervoy were discontinued in 19% of patients and were delayed in 48% of patients for an adverse reaction. 1 About Colorectal Cancer Colorectal cancer (CRC) is cancer that develops in the colon or the rectum, which are part of the body’s digestive or gastrointestinal system. 9 With more than 154,000 new cases estimated to be diagnosed in the United States in 2025, CRC is the third most commonly diagnosed cancer. 7,10 Trends show that incidence is increasing in people younger than 50, and mortality rates have increased in people younger than 55 since the mid-2000s. 7 Mismatch repair deficiency (dMMR) occurs when the proteins that repair mismatch errors in DNA replication are missing or non-functional, leading to microsatellite instability-high (MSI-H) tumors. 11,12 Up to 7% of people with mCRC have MSI-H/dMMR tumors and may often have poor outcomes with standard chemotherapy. 5 INDICATIONS OPDIVO ® (nivolumab), in combination with YERVOY ® (ipilimumab), is indicated for the treatment of adult and pediatric patients 12 years and older with unresectable or metastatic microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR) colorectal cancer (CRC). OPDIVO ® (nivolumab), as a single agent, is indicated for the treatment of adult and pediatric patients 12 years and older with unresectable or metastatic microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR) colorectal cancer (CRC) that has progressed following treatment with a fluoropyrimidine, oxaliplatin, and irinotecan. OPDIVO ® (nivolumab), in combination with YERVOY ® (ipilimumab), is indicated for the treatment of adult patients with hepatocellular carcinoma (HCC) who have been previously treated with sorafenib. This indication is approved under accelerated approval based on overall response rate and duration of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in the confirmatory trials. OPDIVO ® (nivolumab) is indicated for the treatment of adult patients with unresectable advanced, recurrent or metastatic esophageal squamous cell carcinoma (ESCC) after prior fluoropyrimidine- and platinum-based chemotherapy. OPDIVO ® (nivolumab) is indicated for the adjuvant treatment of completely resected esophageal or gastroesophageal junction cancer with residual pathologic disease in adult patients who have received neoadjuvant chemoradiotherapy (CRT). OPDIVO ® (nivolumab), in combination with fluoropyrimidine- and platinum-containing chemotherapy, is indicated for the first-line treatment of adult patients with unresectable advanced or metastatic esophageal squamous cell carcinoma (ESCC). OPDIVO ® (nivolumab), in combination with YERVOY ® (ipilimumab), is indicated for the first-line treatment of adult patients with unresectable advanced or metastatic esophageal squamous cell carcinoma (ESCC). OPDIVO ® (nivolumab), in combination with fluoropyrimidine- and platinum-containing chemotherapy, is indicated for the treatment of adult patients with advanced or metastatic gastric cancer, gastroesophageal junction cancer, and esophageal adenocarcinoma. Please see U.S. Full Prescribing Information for OPDIVO and YERVOY . Clinical Trials and Patient Populations CheckMate-649–previously untreated advanced or metastatic gastric cancer, gastroesophageal junction and esophageal adenocarcinoma; CheckMate-577–adjuvant treatment of esophageal or gastroesophageal junction cancer; 8HW: Previously CheckMate-142–MSI-H or dMMR metastatic colorectal cancer in combination with YERVOY; 8HW: Previously CheckMate-142–MSI-H or dMMR metastatic colorectal cancer, as a single agent; Attraction-3–esophageal squamous cell carcinoma; CheckMate-648—previously untreated, unresectable advanced recurrent or metastatic esophageal squamous cell carcinoma in combination with chemotherapy; CheckMate-648—previously untreated, unresectable advanced recurrent or metastatic esophageal squamous cell carcinoma combination with YERVOY; CheckMate-040–hepatocellular carcinoma, in combination with YERVOY. Bristol Myers Squibb: Creating a Better Future for People with Cancer Bristol Myers Squibb is inspired by a single vision — transforming patients’ lives through science. The goal of the company’s cancer research is to deliver medicines that offer each patient a better, healthier life and to make cure a possibility. Building on a legacy across a broad range of cancers that have changed survival expectations for many, Bristol Myers Squibb researchers are exploring new frontiers in personalized medicine and, through innovative digital platforms, are turning data into insights that sharpen their focus. Deep understanding of causal human biology, cutting-edge capabilities and differentiated research platforms uniquely position the company to approach cancer from every angle. Cancer can have a relentless grasp on many parts of a patient’s life, and Bristol Myers Squibb is committed to taking actions to address all aspects of care, from diagnosis to survivorship. 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About the Bristol Myers Squibb and Ono Pharmaceutical Collaboration In 2011, through a collaboration agreement with Ono Pharmaceutical Co., Bristol Myers Squibb expanded its territorial rights to develop and commercialize Opdivo globally, except in Japan, South Korea and Taiwan, where Ono had retained all rights to the compound at the time. On July 23, 2014, Ono and Bristol Myers Squibb further expanded the companies’ strategic collaboration agreement to jointly develop and commercialize multiple immunotherapies – as single agents and combination regimens – for patients with cancer in Japan, South Korea and Taiwan. About Bristol Myers Squibb Bristol Myers Squibb is a global biopharmaceutical company whose mission is to discover, develop and deliver innovative medicines that help patients prevail over serious diseases. For more information about Bristol Myers Squibb, visit us at BMS.com or follow us on LinkedIn , X , YouTube , Facebook and Instagram . References SOURCE: Bristol Myers Squibb