- Data on Yervoy® (ipilimumab) and the investigational PD-1 receptor blocking antibody nivolumab, to be highlighted in six oral presentations and featured in ASCO press briefings
- Extended follow-up from Phase 1 nivolumab study, results from Phase 1 nivolumab and Yervoy combination study, and five-year survival data from four Phase 2 Yervoy studies to be presented
- Development program for nivolumab now includes seven potentially registrational trials in non-small-cell lung cancer, advanced melanoma and renal cell carcinoma
Bristol-Myers
Squibb Company (NYSE: BMY) today announced that new data on its
approved and investigational immuno-oncology compounds, Yervoy and
the investigational PD-1 receptor blocking antibody nivolumab, will be
featured in six oral presentations at the 49th Annual Meeting
of the American Society of Clinical Oncology (ASCO) in Chicago from May
31 - June 4. The data further characterize the company’s cancer
immunotherapies and underscore the potential of immuno-oncology as a new
treatment modality in a range of cancers.
“At Bristol-Myers Squibb, we continue to pioneer important research in
the field of immuno-oncology, a rapidly evolving, innovative approach to
cancer treatment focused on agents that work directly with the body’s
immune system to fight tumor cells,” said Michael Giordano, senior vice
president, Head of Development, Oncology & Immunology, Bristol-Myers
Squibb. “Our ultimate goal with immuno-oncology is to improve patient
outcomes and long-term survival across a broad range of cancers.”
Data from a Phase 1 trial combining nivolumab and Yervoy (Study
004) in patients with advanced melanoma were featured during the ASCO
press briefing on Wednesday, May 15 and will be presented during an oral
session on Sunday, June 2 (Abstract #9012). This is the first clinical
trial to combine two immune-checkpoint inhibitors, targeting two
distinct checkpoint pathways: PD-1 and CTLA-4. Additionally, extended
follow-up safety and efficacy data, including one- and two-year survival
endpoints, from an expanded Phase 1 trial of nivolumab (Study 003)
monotherapy in advanced non-small-cell lung cancer (NSCLC), advanced
melanoma and renal cell carcinoma (RCC) will be presented during oral
sessions on Saturday, June 1 (Abstract #9006) and Monday, June 3
(Abstract #3002). Results from this study will also be featured during
the ASCO press briefing on June 1. Based on data from these Phase 1
trials, Bristol-Myers Squibb accelerated its development program for
nivolumab last year and now has seven potentially registrational trials
in NSCLC, advanced melanoma and RCC.
Additional data on Yervoy will be presented in 18 abstracts at
the meeting, including five-year survival results from four Phase 2
trials (Study 025) in patients with metastatic melanoma (Abstract
#9053). The company also has a robust Phase 3 development program
ongoing for Yervoy, including Phase 3 clinical trials in NSCLC,
small-cell lung cancer, castration-resistant prostate cancer and
adjuvant melanoma.
In addition to data from Bristol-Myers Squibb’s immuno-oncology
portfolio, the company will announce study results on other compounds in
its oncology franchise. Bristol-Myers Squibb and its partner, AbbVie,
will present updated Phase 2 safety and efficacy results on elotuzumab
plus lenalidomide and low-dose dexamethasone in patients with relapsed
multiple myeloma (Abstract #8542). Elotuzumab, an investigational
compound in Phase 3 development, is a humanized monoclonal antibody that
targets a cell-surface protein called CS1 that is highly expressed on
multiple myeloma cells. Phase 3 clinical trials for elotuzumab in
previously untreated and relapsed multiple myeloma are ongoing. Erbitux®
(cetuximab) data in abstracts that span a range of investigational uses
in solid tumors such as colorectal cancer will also be presented by
Bristol-Myers Squibb and its partner, Lilly.
YERVOY® (ipilimumab) INDICATIONS & IMPORTANT
SAFETY INFORMATION
YERVOY is indicated for the treatment of unresectable or metastatic
melanoma.
Important Safety Information
WARNING: IMMUNE-MEDIATED ADVERSE REACTIONS
YERVOY can result in severe and fatal immune-mediated adverse
reactions due to T-cell activation and proliferation. These
immune-mediated reactions may involve any organ system; however, the
most common severe immune-mediated adverse reactions are enterocolitis,
hepatitis, dermatitis (including toxic epidermal necrolysis),
neuropathy, and endocrinopathy. The majority of these immune-mediated
reactions initially manifested during treatment; however, a minority
occurred weeks to months after discontinuation of YERVOY.
Assess patients for signs and symptoms of enterocolitis, dermatitis,
neuropathy, and endocrinopathy and evaluate clinical chemistries
including liver function tests (LFTs) and thyroid function tests at
baseline and before each dose.
Permanently discontinue YERVOY and initiate systemic high-dose
corticosteroid therapy for severe immune-mediated reactions.
Recommended Dose Modifications
Withhold dose for any moderate immune-mediated adverse reactions or for
symptomatic endocrinopathy until return to baseline, improvement to mild
severity, or complete resolution, and patient is receiving <7.5 mg
prednisone or equivalent per day.
Permanently discontinue YERVOY for any of the following:
-
Persistent moderate adverse reactions or inability to reduce
corticosteroid dose to 7.5 mg prednisone or equivalent per day
-
Failure to complete full treatment course within 16 weeks from
administration of first dose
-
Severe or life-threatening adverse reactions, including any of the
following
-
Colitis with abdominal pain, fever, ileus, or peritoneal signs;
increase in stool frequency (≥7 over baseline), stool
incontinence, need for intravenous hydration for >24 hours,
gastrointestinal hemorrhage, and gastrointestinal perforation
-
AST or ALT >5 × the upper limit of normal (ULN) or total bilirubin
>3 × the ULN
-
Stevens-Johnson syndrome, toxic epidermal necrolysis, or rash
complicated by full-thickness dermal ulceration or necrotic,
bullous, or hemorrhagic manifestations
-
Severe motor or sensory neuropathy, Guillain-Barré syndrome, or
myasthenia gravis
-
Severe immune-mediated reactions involving any organ system
-
Immune-mediated ocular disease which is unresponsive to topical
immunosuppressive therapy
Immune-mediated Enterocolitis:
-
In the pivotal Phase 3 study in YERVOY-treated patients, severe,
life-threatening or fatal (diarrhea of ≥7 stools above baseline,
fever, ileus, peritoneal signs; Grade 3-5) immune-mediated
enterocolitis occurred in 34 (7%) and moderate (diarrhea with up to 6
stools above baseline, abdominal pain, mucus or blood in stool; Grade
2) enterocolitis occurred in 28 (5%) patients
-
Across all YERVOY-treated patients (n=511), 5 (1%) developed
intestinal perforation, 4 (0.8%) died as a result of complications,
and 26 (5%) were hospitalized for severe enterocolitis
-
Infliximab was administered to 5 of 62 (8%) patients with moderate,
severe, or life-threatening immune-mediated enterocolitis following
inadequate response to corticosteroids
-
Monitor patients for signs and symptoms of enterocolitis (such as
diarrhea, abdominal pain, mucus or blood in stool, with or without
fever) and of bowel perforation (such as peritoneal signs and ileus).
In symptomatic patients, rule out infectious etiologies and consider
endoscopic evaluation for persistent or severe symptoms
-
Permanently discontinue YERVOY in patients with severe enterocolitis
and initiate systemic corticosteroids (1-2 mg/kg/day of prednisone or
equivalent). Upon improvement to ≤Grade 1, initiate corticosteroid
taper and continue over at least 1 month. In clinical trials, rapid
corticosteroid tapering resulted in recurrence or worsening symptoms
of enterocolitis in some patients
-
Withhold YERVOY for moderate enterocolitis; administer anti-diarrheal
treatment and, if persistent for >1 week, initiate systemic
corticosteroids (0.5 mg/kg/day prednisone or equivalent)
Immune-mediated Hepatitis:
-
In the pivotal Phase 3 study in YERVOY-treated patients, severe,
life-threatening, or fatal hepatotoxicity (AST or ALT elevations >5x
the ULN or total bilirubin elevations >3x the ULN; Grade 3–5) occurred
in 8 (2%) patients, with fatal hepatic failure in 0.2% and
hospitalization in 0.4%
-
13 (2.5%) additional YERVOY-treated patients experienced moderate
hepatotoxicity manifested by LFT abnormalities (AST or ALT elevations
>2.5x but ≤5x the ULN or total bilirubin elevation >1.5x but ≤3x the
ULN; Grade 2)
-
Monitor LFTs (hepatic transaminase and bilirubin levels) and assess
patients for signs and symptoms of hepatotoxicity before each dose of
YERVOY. In patients with hepatotoxicity, rule out infectious or
malignant causes and increase frequency of LFT monitoring until
resolution
-
Permanently discontinue YERVOY in patients with Grade 3-5
hepatotoxicity and administer systemic corticosteroids (1-2 mg/kg/day
of prednisone or equivalent). When LFTs show sustained improvement or
return to baseline, initiate corticosteroid tapering and continue over
1 month. Across the clinical development program for YERVOY,
mycophenolate treatment has been administered in patients with
persistent severe hepatitis despite high-dose corticosteroids
-
Withhold YERVOY in patients with Grade 2 hepatotoxicity
Immune-mediated Dermatitis:
-
In the pivotal Phase 3 study in YERVOY-treated patients, severe,
life-threatening or fatal immune-mediated dermatitis (e.g.,
Stevens-Johnson syndrome, toxic epidermal necrolysis, or rash
complicated by full thickness dermal ulceration, or necrotic, bullous,
or hemorrhagic manifestations; Grade 3–5) occurred in 13 (2.5%)
patients
-
1 (0.2%) patient died as a result of toxic epidermal necrolysis
-
1 additional patient required hospitalization for severe dermatitis
-
There were 63 (12%) YERVOY-treated patients with moderate (Grade 2)
dermatitis
-
Monitor patients for signs and symptoms of dermatitis such as rash and
pruritus. Unless an alternate etiology has been identified, signs or
symptoms of dermatitis should be considered immune-mediated
-
Permanently discontinue YERVOY in patients with severe,
life-threatening, or fatal immune-mediated dermatitis (Grade 3-5).
Administer systemic corticosteroids (1-2 mg/kg/day of prednisone or
equivalent). When dermatitis is controlled, corticosteroid tapering
should occur over a period of at least 1 month. Withhold YERVOY in
patients with moderate to severe signs and symptoms
-
Treat mild to moderate dermatitis (e.g., localized rash and pruritus)
symptomatically. Administer topical or systemic corticosteroids if
there is no improvement within 1 week
Immune-mediated Neuropathies:
-
In the pivotal Phase 3 study in YERVOY-treated patients, 1 case of
fatal Guillain-Barré syndrome and 1 case of severe (Grade 3)
peripheral motor neuropathy were reported
-
Across the clinical development program of YERVOY, myasthenia gravis
and additional cases of Guillain-Barré syndrome have been reported
-
Monitor for symptoms of motor or sensory neuropathy such as unilateral
or bilateral weakness, sensory alterations, or paresthesia.
Permanently discontinue YERVOY in patients with severe neuropathy
(interfering with daily activities) such as Guillain-Barré–like
syndromes
-
Institute medical intervention as appropriate for management of severe
neuropathy. Consider initiation of systemic corticosteroids (1-2
mg/kg/day of prednisone or equivalent) for severe neuropathies.
Withhold YERVOY in patients with moderate neuropathy (not interfering
with daily activities)
Immune-mediated Endocrinopathies:
-
In the pivotal Phase 3 study in YERVOY- treated patients, severe to
life-threatening immune-mediated endocrinopathies (requiring
hospitalization, urgent medical intervention, or interfering with
activities of daily living; Grade 3-4) occurred in 9 (1.8%) patients
-
All 9 patients had hypopituitarism, and some had additional
concomitant endocrinopathies such as adrenal insufficiency,
hypogonadism, and hypothyroidism.
-
6 of the 9 patients were hospitalized for severe endocrinopathies
-
Moderate endocrinopathy (requiring hormone replacement or medical
intervention; Grade 2) occurred in 12 (2.3%) YERVOY-treated patients
and consisted of hypothyroidism, adrenal insufficiency,
hypopituitarism, and 1 case each of hyperthyroidism and Cushing’s
syndrome
-
Median time to onset of moderate to severe immune-mediated
endocrinopathy was 11 weeks and ranged up to 19.3 weeks after the
initiation of YERVOY
-
Monitor patients for clinical signs and symptoms of hypophysitis,
adrenal insufficiency (including adrenal crisis), and hyper- or
hypothyroidism
-
Patients may present with fatigue, headache, mental status
changes, abdominal pain, unusual bowel habits, and hypotension, or
nonspecific symptoms which may resemble other causes such as brain
metastasis or underlying disease. Unless an alternate etiology has
been identified, signs or symptoms should be considered
immune-mediated
-
Monitor thyroid function tests and clinical chemistries at the
start of treatment, before each dose, and as clinically indicated
based on symptoms. In a limited number of patients, hypophysitis
was diagnosed by imaging studies through enlargement of the
pituitary gland
-
Withhold YERVOY in symptomatic patients. Initiate systemic
corticosteroids (1-2 mg/kg/day of prednisone or equivalent) and
initiate appropriate hormone replacement therapy. Long-term hormone
replacement therapy may be necessary
Other Immune-mediated Adverse Reactions, Including Ocular
Manifestations:
-
In the pivotal Phase 3 study in YERVOY-treated patients, clinically
significant immune-mediated adverse reactions seen in <1% were:
nephritis, pneumonitis, meningitis, pericarditis, uveitis, iritis, and
hemolytic anemia
-
Across the clinical development program for YERVOY, immune-mediated
adverse reactions also reported with <1% incidence were: myocarditis,
angiopathy, temporal arteritis, vasculitis, polymyalgia rheumatica,
conjunctivitis, blepharitis, episcleritis, scleritis, leukocytoclastic
vasculitis, erythema multiforme, psoriasis, pancreatitis, arthritis,
and autoimmune thyroiditis
-
Permanently discontinue YERVOY for clinically significant or severe
immune-mediated adverse reactions. Initiate systemic corticosteroids
(1-2 mg/kg/day of prednisone or equivalent) for severe immune-mediated
adverse reactions
-
Administer corticosteroid eye drops for uveitis, iritis, or
episcleritis. Permanently discontinue YERVOY for immune-mediated
ocular disease unresponsive to local immunosuppressive therapy
Pregnancy & Nursing:
-
YERVOY is classified as pregnancy category C. There are no adequate
and well-controlled studies of YERVOY in pregnant women. Use YERVOY
during pregnancy only if the potential benefit justifies the potential
risk to the fetus
-
Human IgG1 is known to cross the placental barrier and YERVOY is an
IgG1; therefore, YERVOY has the potential to be transmitted from the
mother to the developing fetus
-
It is not known whether YERVOY is secreted in human milk. Because many
drugs are secreted in human milk and because of the potential for
serious adverse reactions in nursing infants from YERVOY, a decision
should be made whether to discontinue nursing or to discontinue YERVOY
Common Adverse Reactions:
-
The most common adverse reactions (≥5%) in patients who received
YERVOY at 3 mg/kg were fatigue (41%), diarrhea (32%), pruritus (31%),
rash (29%), and colitis (8%)
Please see full Prescribing Information, including Boxed WARNING
regarding immune-mediated adverse reactions available at www.bms.com.
YERVOY is a registered trademark of Bristol-Myers Squibb Company.
ERBITUX® (cetuximab) INDICATIONS & IMPORTANT
SAFETY INFORMATION Including BOXED WARNING
INDICATIONS
Head and Neck Cancer
-
ERBITUX® (cetuximab), in combination with
radiation therapy, is indicated for the initial treatment of locally
or regionally advanced squamous cell carcinoma of the head and neck
(SCCHN)
-
ERBITUX is indicated in combination with platinum-based therapy with
5-FU for the first-line treatment of patients with recurrent
locoregional disease or metastatic squamous cell carcinoma of the head
and neck
-
ERBITUX, as a single agent, is indicated for the treatment of patients
with recurrent or metastatic squamous cell carcinoma of the head and
neck for whom prior platinum-based therapy has failed
Colorectal Cancer
ERBITUX is indicated for the treatment of KRAS mutation-negative
(wild-type), epidermal growth factor receptor (EGFR)-expressing,
metastatic colorectal cancer (mCRC) as determined by FDA approved tests
for this use:
-
in combination with FOLFIRI (irinotecan, 5-fluorouracil, leucovorin)
for first-line treatment
-
in combination with irinotecan in patients who are refractory to
irinotecan-based chemotherapy
-
as a single agent in patients who have failed oxaliplatin- and
irinotecan-based chemotherapy or who are intolerant to irinotecan
Limitation of Use: ERBITUX is not indicated for treatment of KRAS mutation-positive
colorectal cancer
IMPORTANT SAFETY INFORMATION INCLUDING BOXED WARNINGS
Infusion Reactions
-
Grade 3/4 infusion reactions occurred in approximately 3% of
patients receiving ERBITUX® (cetuximab) in
clinical trials, with fatal outcome reported in less than 1 in 1000
-
Serious infusion reactions, requiring medical intervention and
immediate, permanent discontinuation of ERBITUX, included rapid
onset of airway obstruction (bronchospasm, stridor, hoarseness),
hypotension, shock, loss of consciousness, myocardial infarction,
and/or cardiac arrest
-
Immediately interrupt and permanently discontinue ERBITUX
infusions for serious infusion reactions
-
Approximately 90% of the severe infusion reactions were associated
with the first infusion of ERBITUX despite premedication with
antihistamines
-
Caution must be exercised with every ERBITUX infusion, as there
were patients who experienced their first severe infusion reaction
during later infusions
-
Monitor patients for 1 hour following ERBITUX infusions in a
setting with resuscitation equipment and other agents necessary to
treat anaphylaxis (e.g., epinephrine, corticosteroids, intravenous
antihistamines, bronchodilators, and oxygen). Longer observation
periods may be required in patients who require treatment for
infusion reactions
Cardiopulmonary Arrest
-
Cardiopulmonary arrest and/or sudden death occurred in 4 (2%) of
208 patients with squamous cell carcinoma of the head and neck treated
with radiation therapy and ERBITUX, as compared to none of 212
patients treated with radiation therapy alone. In 3 patients with
prior history of coronary artery disease, death occurred 27, 32, and
43 days after the last dose of ERBITUX. One patient with no prior
history of coronary artery disease died one day after the last dose of
ERBITUX. Fatal cardiac disorders and/or sudden death occurred in 7
(3%) of the 219 patients with squamous cell carcinoma of the head and
neck treated with platinum-based therapy with 5-fluorouracil (5-FU)
and European Union (EU)-approved cetuximab as compared to 4 (2%) of
the 215 patients treated with chemotherapy alone. Five of these 7
patients in the chemotherapy plus cetuximab arm received concomitant
cisplatin and 2 patients received concomitant carboplatin. All 4
patients in the chemotherapy-alone arm received cisplatin
-
Carefully consider the use of ERBITUX in combination with
radiation therapy or platinum-based therapy with 5-FU in head and
neck cancer patients with a history of coronary artery disease,
congestive heart failure, or arrhythmias in light of these
risks
-
Closely monitor serum electrolytes, including serum magnesium,
potassium, and calcium during and after ERBITUX therapy
Pulmonary Toxicity
-
Interstitial lung disease (ILD), which was fatal in one case, occurred
in 4 of 1570 (<0.5%) patients receiving ERBITUX in Studies 1, 3, and
6, as well as other studies, in colorectal cancer and head and neck
cancer. Interrupt ERBITUX for acute onset or worsening of pulmonary
symptoms. Permanently discontinue ERBITUX for confirmed ILD
Dermatologic Toxicities
-
In clinical studies of ERBITUX, dermatologic toxicities, including
acneiform rash, skin drying and fissuring, paronychial inflammation,
infectious sequelae (e.g., S. aureus sepsis, abscess formation,
cellulitis, blepharitis, conjunctivitis, keratitis/ulcerative
keratitis with decreased visual acuity, cheilitis), and
hypertrichosis, occurred in patients receiving ERBITUX therapy.
Acneiform rash occurred in 76-88% of 1373 patients receiving ERBITUX
in Studies 1, 3, 5, and 6. Severe acneiform rash occurred in 1-17% of
patients
-
Acneiform rash usually developed within the first 2 weeks of
therapy and resolved in a majority of the patients after cessation
of treatment, although in nearly half, the event continued beyond
28 days
-
Monitor patients receiving ERBITUX for dermatologic toxicities and
infectious sequelae
-
Sun exposure may exacerbate these effects
ERBITUX Plus Radiation Therapy and Cisplatin
-
In a controlled study, 940 patients with locally advanced SCCHN were
randomized 1:1 to receive either ERBITUX in combination with radiation
therapy and cisplatin or radiation therapy and cisplatin alone. The
addition of ERBITUX resulted in an increase in the incidence of Grade
3-4 mucositis, radiation recall syndrome, acneiform rash, cardiac
events, and electrolyte disturbances compared to radiation and
cisplatin alone Adverse reactions with fatal outcome were reported in
20 patients (4.4%) in the ERBITUX combination arm and 14 patients
(3.0%) in the control arm
-
Nine patients in the ERBITUX arm (2.0%) experienced myocardial
ischemia compared to 4 patients (0.9%) in the control arm The addition
of ERBITUX to radiation and cisplatin did not improve progression-free
survival (the primary endpoint)
Electrolyte Depletion
-
Hypomagnesemia occurred in 55% of 365 patients receiving ERBITUX in
Study 5 and two other clinical trials in colorectal cancer and head
and neck cancer, respectively, and was severe (NCI CTC grades 3 & 4)
in 6-17%. In Study 2 the addition of EU-approved cetuximab to
cisplatin and 5-FU resulted in an increased incidence of
hypomagnesemia (14% vs 6%) and of grade 3–4 hypomagnesemia (7% vs 2%)
compared to cisplatin and 5-FU alone. In contrast, the incidences of
hypomagnesemia were similar for those who received cetuximab,
carboplatin, and 5-FU compared to carboplatin and 5-FU (4% vs 4%). No
patient experienced grade 3–4 hypomagnesemia in either arm in the
carboplatin subgroup. The onset of hypomagnesemia and accompanying
electrolyte abnormalities occurred days to months after initiation of
ERBITUX therapy
-
Monitor patients periodically for hypomagnesemia, hypocalcemia,
and hypokalemia, during, and for at least 8 weeks following the
completion of, ERBITUX therapy
-
Replete electrolytes as necessary
Late Radiation Toxicities
-
The overall incidence of late radiation toxicities (any grade) was
higher with ERBITUX in combination with radiation therapy compared
with radiation therapy alone. The following sites were affected:
salivary glands (65% vs 56%), larynx (52% vs 36%), subcutaneous tissue
(49% vs 45%), mucous membranes (48% vs 39%), esophagus (44% vs 35%),
and skin (42% vs 33%) in the ERBITUX and radiation versus radiation
alone arms, respectively
-
The incidences of grade 3 or 4 late radiation toxicities were
similar between the radiation therapy alone and the ERBITUX plus
radiation therapy arms
Pregnancy and Nursing
-
In women of childbearing potential, appropriate contraceptive measures
must be used during treatment with ERBITUX and for 6 months following
the last dose of ERBITUX. ERBITUX may be transmitted from the mother
to the developing fetus, and has the potential to cause fetal harm
when administered to pregnant women. ERBITUX should only be used
during pregnancy if the potential benefit justifies the potential risk
to the fetus
-
It is not known whether ERBITUX is secreted in human milk. IgG
antibodies, such as ERBITUX, can be excreted in human milk. Because of
the potential for serious adverse reactions in nursing infants from
ERBITUX, a decision should be made whether to discontinue nursing or
to discontinue ERBITUX, taking into account the importance of ERBITUX
to the mother. If nursing is interrupted, based on the mean half-life
of cetuximab, nursing should not be resumed earlier than 60 days
following the last dose of ERBITUX
Adverse Reactions
-
The most serious adverse reactions associated with ERBITUX are
infusion reactions, cardiopulmonary arrest, dermatologic toxicity and
radiation dermatitis, sepsis, renal failure, interstitial lung
disease, and pulmonary embolus
-
The most common adverse reactions associated with ERBITUX (incidence
≥25%) across all studies were cutaneous adverse reactions (including
rash, pruritus, and nail changes), headache, diarrhea, and infection
-
The most frequent adverse reactions seen in patients with carcinomas
of the head and neck receiving ERBITUX in combination with radiation
therapy (n=208) versus radiation alone (n=212) (incidence ≥50%) were
acneiform rash (87% vs 10%), radiation dermatitis (86% vs 90%), weight
loss (84% vs 72%), and asthenia (56% vs 49%). The most common grade
3/4 adverse reactions for ERBITUX in combination with radiation
therapy (≥10%) versus radiation alone included: radiation dermatitis
(23% vs 18%), acneiform rash (17% vs 1%), and weight loss (11% vs 7%)
-
The most frequent adverse reactions seen in patients with carcinomas
of the head and neck receiving EU-approved cetuximab in combination
with platinum-based therapy with 5-FU (CT) (n=219) versus CT alone
(n=215) (incidence ≥40%) were acneiform rash (70% vs 2%), nausea (54%
vs 47%), and infection (44% vs 27%). The most common grade 3/4 adverse
reactions for cetuximab in combination with CT (≥10%) versus CT alone
included: infection (11% vs 8%). Since U.S.-licensed ERBITUX provides
approximately 22% higher exposure relative to the EU-approved
cetuximab, the data provided above may underestimate the incidence and
severity of adverse reactions anticipated with ERBITUX for this
indication. However, the tolerability of the recommended dose is
supported by safety data from additional studies of ERBITUX
-
The most frequent adverse reactions seen in patients with KRAS mutation-negative
(wild-type), EGFR-expressing metastatic colorectal cancer treated with
EU-approved cetuximab + FOLFIRI (n=317) versus FOLFIRI alone (n=350)
(incidence ≥50%) were acne-like rash (86% vs 13%) and diarrhea (66% vs
60%). The most common grade 3/4 adverse reactions (≥10%) included:
neutropenia (31% vs 24%), acne-like rash (18% vs <1%), and diarrhea
(16% vs 10%). U.S.-licensed ERBITUX provides approximately 22% higher
exposure to cetuximab relative to the EU-approved cetuximab. The data
provided above are consistent in incidence and severity of adverse
reactions with those seen for ERBITUX in this indication. The
tolerability of the recommended dose is supported by safety data from
additional studies of ERBITUX
-
The most frequent adverse reactions seen in patients with KRAS mutation-negative
(wild-type), EGFR-expressing metastatic colorectal cancer treated with
ERBITUX + best supportive care (BSC) (n=118) versus BSC alone (n=124)
(incidence ≥50%) were rash/desquamation (95% vs 21%), fatigue (91% vs
79%), nausea (64% vs 50%), dry skin (57% vs 15%), pain-other (59% vs
37%), and constipation (53% vs 38%). The most common grade 3/4 adverse
reactions (≥10%) included: fatigue (31% vs 29%), pain-other (18% vs
10%), rash/desquamation (16% vs 1%), dyspnea (16% vs 13%),
other-gastrointestinal (12% vs 5%), and infection without neutropenia
(11% vs 5%)
-
The most frequent adverse reactions seen in patients with
EGFR-expressing metastatic colorectal cancer (n=354) treated with
ERBITUX plus irinotecan in clinical trials (incidence ≥50%) were
acneiform rash (88%), asthenia/malaise (73%), diarrhea (72%), and
nausea (55%). The most common grade 3/4 adverse reactions (≥10%)
included: diarrhea (22%), leukopenia (17%), asthenia/malaise (16%),
and acneiform rash (14%)
Please see Important Safety Information and U.S.
Full Prescribing Information including Boxed WARNINGS.
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 www.bms.com,
or follow us on Twitter at http://twitter.com/bmsnews.
This press release contains "forward-looking statements" as that term
is defined in the Private Securities Litigation Reform Act of 1995
regarding the research, development and commercialization of
pharmaceutical products. Such forward-looking statements are based on
current expectations and involve inherent risks and uncertainties,
including factors that could delay, divert or change any of them, and
could cause actual outcomes and results to differ materially from
current expectations. No forward-looking statement can be guaranteed.
Among other risks, there can be no guarantee that the investigational
compounds described in this release will receive regulatory approvals
or, if approved, that they will become commercially successful products.
There is also no guarantee that the investigational uses of
currently-approved products described in this release will lead to
additional approved indications for such products. Forward-looking
statements in this press release should be evaluated together with the
many uncertainties that affect Bristol-Myers Squibb's business,
particularly those identified in the cautionary factors discussion in
Bristol-Myers Squibb's Annual Report on Form 10-K for the year ended
December 31, 2012, in our Quarterly Reports on Form 10-Q and our Current
Reports on Form 8-K. Bristol-Myers Squibb undertakes no obligation to
publicly update any forward-looking statement, whether as a result of
new information, future events or otherwise.

Bristol-Myers Squibb CompanyMedia:Sarah Koenig, 609-252-4145sarah.koenig@bms.comorInvestors:John Elicker, 609-252-4611john.elicker@bms.com