Oncologists’ Perceptions of Nivolumab Plus Ipilumumab (NIVO + IPI) As First-Line (1L) Treatment for Microsatellite Instability-High/Mismatch Repair-Deficient (MSI-H/dMMR) Metastatic Colorectal Cancer (mCRC)

OBJECTIVES: NIVO + IPI are FDA-approved for patients with MSI-H/dMMR mCRC with disease progression after chemotherapy treatment. The phase III CheckMate 8HW (NCT04008030) trial demonstrated superior progression-free survival (PFS), and fewer grade 3-4 treatment-related adverse events for NIVO + IPI versus chemotherapy in previously untreated patients with MSI-H/dMMR mCRC. We conducted a survey of practicing oncologist within the U.S to understand their perceptions about the trial and how it might inform patient care in the future.

METHODS: In a live meeting, using an audience response system and verbal dialogue, U.S-based oncologists were queried on their perceptions of Checkmate 8HW trial data and anticipated NIVO + IPI use for 1L treatment of MSI-H/dMMR mCRC. Data were summarized descriptively.

RESULTS: There were 54 practicing oncologists in the meeting, though not all participants answered all questions. They had a mean of 20 years in practice, 77% were in community settings, and geographically dispersed. 89% treated colorectal cancer and had an average of 30 current and 7 referred colorectal patients in a typical 3-month period. Following the CheckMate 8HW trial data presentation, preference for NIVO + IPI regimen as 1L therapy for a 65-year-old male patient with an ECOG PS of 1, a KRAS mutation, and MSI-H/dMMR mCRC increased by 66 percentage points (20% to 86%) among respondents. Most (83%) found the 24-month PFS rates for NIVO + IPI versus chemotherapy to be the most clinically meaningful data.

CONCLUSIONS: Evidence based medicine helps to improve uptake of new oncologic regimens. This study provides evidence that most oncologists prefer to treat patients with MSI-H/dMMR mCRC using 1L NIVO + IPI, citing its superior performance over chemotherapy in the CheckMate 8HW trial. This insight may inform practice guidelines and support the use of 1L NIVO + IPI as a viable treatment option in this patient population.