Regorafenib as monotherapy has demonstrated an overall survival benefit versus placebo in the pivotal Phase III CORRECT study and has shown activity irrespective of micro-satellite status in a retrospective analysis from this study, though with limited responses observed.(2,3) Despite progress in the treatment of CRC, including the advance of effective immuno-oncology (I-O) treatments for certain subsets of CRC, around 95% of mCRC patients have MSS tumors, for which I-O monotherapy treatment approaches have shown limited activity.(4) Thus, the need for additional treatment options including combination approaches remains high.(4) Encouraging early data have been seen with the combination of regorafenib and nivolumab. In a Phase 1b investigator sponsored trial from Japan called REGONIVO (NCT03406871, EPOC1603), the combination of regorafenib and nivolumab has shown promising preliminary efficacy results.(1) The detailed data of the study were presented at the 2019 American Society of Clinical Oncology (ASCO) Annual Meeting.
"The data seen in REGONIVO warrant further exploration of the combination of regorafenib and nivolumab in patients with colorectal cancer. Regorafenib has proven its efficacy and positive safety profile as a third-line monotherapy and we are excited to enter into a clinical collaboration to evaluate this combination with the hope to deliver an additional therapeutic benefit to patients," said Scott Z. Fields, M.D., senior vice president and head of Oncology Development at Bayer's Pharmaceuticals Division.
"We continue to invest in innovative approaches to maximize the potential of our pipeline, and interrogate new combinations to help more patients with cancers typically not responsive to I-O therapy," said Fouad Namouni, M.D., head of development, oncology, Bristol-Myers Squibb. "We are looking forward to a strong collaboration to investigate nivolumab with regorafenib, with the goal of serving more patients who have cancer."
"We have been actively engaged in the development of nivolumab including combination therapies with other agents. We are excited to initiate the clinical collaboration with Bayer and Bristol-Myers Squibb to investigate this combination therapy as a new treatment option for patients with colorectal cancer and other types of cancer," said Kiyoaki Idemitsu, Corporate Officer, Executive Director, Clinical Development, Ono.
Further terms of the clinical collaboration were not disclosed.
About Colorectal CancerColorectal cancer(5) is a cancer that starts in the colon or the rectum. In the U.S., it is currently the third most common cancer diagnosed and the second leading cause of cancer-related deaths when estimates for men and women are combined. In 2019, an estimated 145,600 Americans will be diagnosed with colorectal cancer. General estimates predict that 1 in 23 will be diagnosed with the disease in their lifetime.
About Stivarga® (regorafenib)In April 2017, Stivarga (6) was approved for use in patients with hepatocellular carcinoma who have been previously treated with Nexavar® (sorafenib). In the United States, Stivarga is also indicated for the treatment of patients with metastatic colorectal cancer (CRC) who have been previously treated with fluoropyrimidine-, oxaliplatin- and irinotecan-based chemotherapy, an anti-VEGF therapy, and, if RAS wild-type, an anti-EGFR therapy. It is also indicated for the treatment of patients with locally advanced, unresectable or metastatic gastrointestinal stromal tumor (GIST) who have been previously treated with imatinib mesylate and sunitinib malate.
Regorafenib is a compound developed by Bayer. In 2011, Bayer entered into an agreement with Onyx, now an Amgen subsidiary, under which Onyx receives a royalty on all global net sales of regorafenib in oncology.
Please see full Prescribing Information, including Boxed Warning for Stivarga (regorafenib).
About Oncology at BayerBayer is committed to delivering science for a better life by advancing a portfolio of innovative treatments. The oncology franchise at Bayer includes five marketed products and several other assets in various stages of clinical development. Together, these products reflect the company’s approach to research, which prioritizes targets and pathways with the potential to impact the way that cancer is treated.
About BayerBayer is a global enterprise with core competencies in the life science fields of health care and nutrition. Its products and services are designed to benefit people by supporting efforts to overcome the major challenges presented by a growing and aging global population. At the same time, the Group aims to increase its earning power and create value through innovation and growth. Bayer is committed to the principles of sustainable development, and the Bayer brand stands for trust, reliability and quality throughout the world. In fiscal 2018, the Group employed around 117,000 people and had sales of 39.6 billion euros. Capital expenditures amounted to 2.6 billion euros, R&D expenses to 5.2 billion euros.
About Opdivo® (nivolumab)Opdivo is a programmed death-1 (PD-1) immune checkpoint inhibitor that is designed to uniquely harness the body’s own immune system to help restore anti-tumor immune response. By harnessing the body's own immune system to fight cancer, Opdivo has become an important treatment option across multiple cancers.
Opdivo’s development program includes a broad range of clinical trials across all phases, including Phase 3, in a variety of tumor types. To date, the Opdivo clinical development program has enrolled more than 25,000 patients. The Opdivo trials have contributed to gaining a deeper understanding of the potential role of biomarkers in patient care, particularly regarding how patients may benefit from Opdivo across the continuum of PD-L1 expression.
In July 2014, Opdivo was the first PD-1 immune checkpoint inhibitor to receive regulatory approval anywhere in the world. Opdivo is currently approved in more than 65 countries, including the United States, the European Union, Japan and China. In October 2015, the Company’s Opdivo and Yervoy combination regimen was the first Immuno-Oncology combination to receive regulatory approval for the treatment of metastatic melanoma and is currently approved in more than 50 countries, including the United States and the European Union.
Please see U.S. Full Prescribing Information for OPDIVO and YERVOY, including Boxed WARNING regarding immune-mediated adverse reactions for YERVOY.
Checkmate Trials and Patient PopulationsCheckmate 037-previously treated metastatic melanoma; Checkmate 066–previously untreated metastatic melanoma; Checkmate 067-previously untreated metastatic melanoma, as a single agent or in combination with YERVOY; Checkmate 017-second-line treatment of metastatic squamous non-small cell lung cancer; Checkmate 057-second-line treatment of metastatic non-squamous non-small cell lung cancer; Checkmate 032-small cell lung cancer; Checkmate 025-previously treated renal cell carcinoma; Checkmate 214-previously untreated renal cell carcinoma, in combination with YERVOY; Checkmate 205/039-classical Hodgkin lymphoma; Checkmate 141-recurrent or metastatic squamous cell carcinoma of the head and neck; Checkmate 275-urothelial carcinoma; Checkmate 142-MSI-H or dMMR metastatic colorectal cancer, as a single agent or in combination with YERVOY; Checkmate 040–hepatocellular carcinoma; Checkmate 238-adjuvant treatment of melanoma.
About the Bristol-Myers Squibb and Ono Pharmaceutical CollaborationIn 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 SquibbBristol-Myers Squibb is a global biopharmaceutical company whose mission is to discover, develop and deliver innovative medicines that help patients prevail over serious diseases.
About Bristol-Myers Squibb: Advancing Oncology ResearchAt Bristol-Myers Squibb, patients are at the center of everything we do. The focus of our research is to increase quality, long-term survival for patients and make cure a possibility. Through a unique multidisciplinary approach powered by translational science, we harness our deep scientific experience in oncology and Immuno-Oncology (I-O) research to identify novel treatments tailored to individual patient needs. Our researchers are developing a diverse, purposefully built pipeline designed to target different immune system pathways and address the complex and specific interactions between the tumor, its microenvironment and the immune system. We source innovation internally, and in collaboration with academia, government, advocacy groups and biotechnology companies, to help make the promise of transformational medicines, like I-O, a reality for patients.
1. Fukuoka, S; Hara, H; Takahashi, N et al. Regorafenib in combination with nivolumab in patients with advanced gastric or colorectal cancer: an, open-label, dose-finding, and dose-expansion phase 1b trial (REGONIVO, EPOC1603). American Society of Clinical Oncology 2019; June 2, 2019. Chicago, Illinois. Abstract 2522. 2. Grothey, A; Cutsem, E; Sobrero, A; Siena, S et al. Regorafenib monotherapy for previously treated metastatic colorectal cancer (CORRECT): an international, multicentre, randomised, placebo-controlled, phase 3 trial. Lancet. 2012;381(9863);303-312; January 2013. https://doi.org/10.1016/S0140-6736(12)61900-X. 3. Kochert, K; Beckmann, G; Teufel, M. Exploratory analysis of baseline microsatellite instability (MSI) status in patients with metastatic colorectal cancer (mCRC) treated with regorafenib (REG) or placebo in the phase 3 CORRECT trial. Annals of Oncology. September 2017. https://doi.org/10.1093/annonc/mdx393.060. 4. Prime Oncology. Immunotherapy Advances for Colorectal Carcinoma in 2018: Newly Released Data From the Gastrointestinal Cancers Symposium in San Francisco. https://www.primeoncology.org/app/uploads/prime_sponsors/27/Gastrointestinal-symposium-CRC-immunotherapy-2018-prime-oncology.pdf. Accessed July 2019. 5. American Cancer Society. Key Statistics for Colorectal Cancer. https://www.cancer.org/cancer/colon-rectal-cancer/about/key-statistics.html. Accessed July 2019. 6. Stivarga® (Regorafenib) tablets [Prescribing Information]. Whippany, NJ: Bayer HealthCare Pharmaceuticals, June 2019. 7. OPDIVO (nivolumab) injection, for intravenous use [Prescribing Information]. Princeton, NJ: Bristol-Myers Squibb Company, December 2017.