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CheckMate 498 asked whether nivolumab could replace temozolomide in the glioblastoma patients who gain least from it. Patients given nivolumab lived a shorter time.
CheckMate 498, trial NCT02617589 sponsored by BMS, randomised 560 patients with newly diagnosed glioblastoma and an unmethylated MGMT promoter to standard radiotherapy (60 Gy) with nivolumab or with temozolomide. Median overall survival, the primary endpoint, was 13.4 months with nivolumab and 14.9 months with temozolomide (HR 1.31, 95% CI 1.09-1.58); median progression-free survival was 6.0 versus 6.2 months. Published by Omuro and colleagues in Neuro-Oncology (2023;25:123-134). It is one of three negative phase 3 trials of nivolumab in glioblastoma, with CheckMate 143 at recurrence and CheckMate 548 in MGMT-methylated disease.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
560 enrolled.
Favours temozolomide
Source| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Overall survival, MGMT-unmethylated glioblastomaprimary | Nivolumab + RT | 280 | 13.4 months | 1.31 (1.09 to 1.58) | 0.0037 | link |
| Temozolomide + RT | 280 | 14.9 months |
Shares Neoadjuvant immunotherapy with surgical window for glioblastoma, MGMT promoter methylation, Blood-brain barrier (BBB), Hot vs cold tumours.
Shares Neoadjuvant immunotherapy with surgical window for glioblastoma, Blood-brain barrier (BBB), Hot vs cold tumours, Nivolumab.
Shares MGMT promoter methylation, Temozolomide, Glioma & glioblastoma.
Shares MGMT promoter methylation, Temozolomide, Glioma & glioblastoma, IMRT / IGRT (modern external beam).
Shares MGMT promoter methylation, Temozolomide, Glioma & glioblastoma, IMRT / IGRT (modern external beam).
Shares Temozolomide, Glioma & glioblastoma, Immune checkpoint inhibitors.
Shares MGMT promoter methylation, Temozolomide, Glioma & glioblastoma.
Shares Hot vs cold tumours, Nivolumab, PD-1, Immune checkpoint inhibitors.