Opdualag is a first-in-class, fixed-dose dual      immunotherapy combination treatment of the PD-1 inhibitor      nivolumab and novel LAG-3-blocking antibody      relatlimab    
      In RELATIVITY-047, Opdualag more than doubled median      progression-free survival compared to nivolumab      monotherapy    
    PRINCETON, N.J.--(BUSINESS    WIRE)-- Bristol Myers Squibb (NYSE:    BMY) today announced that the European Commission (EC) has    approved the fixed-dose combination of Opdualag    (nivolumab and relatlimab) for the first-line treatment of    advanced (unresectable or metastatic) melanoma in adults and    adolescents 12 years of age and older with tumor cell PD-L1    expression < 1%.  
    The ECs decision is based upon an exploratory analysis of    results from the Phase 2/3 RELATIVITY-047 trial in patients    with tumor cell expression < 1%, which demonstrated that    treatment with the fixed-dose combination of the PD-1 inhibitor    nivolumab and novel LAG-3-blocking antibody relatlimab more    than doubled the median progression-free survival (PFS)    compared to nivolumab monotherapy  an established standard of    care. No new safety events were identified with the combination    when compared to nivolumab monotherapy.  
    Opdualag is now the first approved LAG-3-blocking    antibody combination for advanced melanoma in the European    Union. The RELATIVITY-047 study demonstrated the important    benefit of inhibiting both LAG-3 and PD-L1 with our novel    immunotherapy combination, said Samit Hirawat, M.D., executive    vice president, chief medical officer, Global Drug Development,    Bristol Myers Squibb. This is a continuation of our work in    bringing innovative medicines to adults and adolescents living    with melanoma. Thank you to all of the patients, researchers    and physicians who contributed to these advancements and made    todays approval possible.  
    The EC decision allows for the use of Opdualag for the    first-line treatment of adults and adolescents 12 years of age    and older with advanced melanoma and tumor cell PD-L1    expression < 1% in all European Union member states*, as    well as Iceland, Liechtenstein, and Norway.  
    RELATIVITY -047 Efficacy and Safety    Results  
    The indication in the European Union is based upon an    exploratory analysis of the RELATIVITY-047 data in patients    with tumor cell PD-L1 expression < 1%:  
    The RELATIVITY-047 trial also met its primary endpoint of PFS    in the all-comer population.  
    *Centralized Marketing Authorization does not include    approval in Great Britain (England, Scotland, Wales).  
    About RELATIVITY-047  
    RELATIVITY-047 is a global, randomized, double-blind Phase 2/3    study evaluating the fixed-dose combination of nivolumab and    relatlimab versus nivolumab alone in patients with previously    untreated metastatic or unresectable melanoma. Patients were    enrolled regardless of tumor cell PD-L1 expression. The trial    excluded patients with active autoimmune disease, medical    conditions requiring systemic treatment with moderate or high    dose corticosteroids or immunosuppressive medications, uveal    melanoma, and active or untreated brain or leptomeningeal    metastases. The primary endpoint of the trial is    progression-free survival (PFS) determined by Blinded    Independent Central Review (BICR) using Response Evaluation    Criteria in Solid Tumors (RECIST v1.1) in the all-comer    population. The secondary endpoints are overall survival (OS)    and objective response rate (ORR) in the all-comer population.    A total of 714 patients were randomized 1:1 to receive a    fixed-dose combination of nivolumab (480 mg) and relatlimab    (160 mg) or nivolumab (480 mg) by intravenous infusion every    four weeks until disease progression, unacceptable toxicity or    withdrawal of consent.  
    About LAG-3  
    Lymphocyte-activation gene 3 (LAG-3) is a cell-surface molecule    expressed on effector T cells and regulatory T cells (Tregs)    and functions to control T-cell response, activation and    growth. Preclinical studies indicate that inhibition of LAG-3    may restore effector function of exhausted T cells and    potentially promote an anti-tumor response. Early research    demonstrates that targeting LAG-3 in combination with other    potentially complementary immune checkpoints may be a key    strategy to more effectively potentiate anti-tumor immune    activity.  
    Bristol Myers Squibb is evaluating relatlimab, its    LAG-3-blocking antibody, in clinical trials in combination with    other agents in a variety of tumor types.  
    About Melanoma  
    Melanoma is a form of skin cancer characterized by the    uncontrolled growth of pigment-producing cells (melanocytes)    located in the skin. Metastatic melanoma is the deadliest form    of the disease and occurs when cancer spreads beyond the    surface of the skin to other organs. The incidence of melanoma    has been increasing steadily for the last 30 years. In the    United States, 106,110 new diagnoses of melanoma and about    7,180 related deaths are estimated for 2021. Globally, the    World Health Organization estimates that by 2035, melanoma    incidence will reach 424,102, with 94,308 related deaths.    Melanoma can be mostly treatable when caught in its very early    stages; however, survival rates can decrease as the disease    progresses.  
    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    companys 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 scientific expertise, cutting-edge capabilities and    discovery platforms enable the company to look at cancer from    every angle. Cancer can have a relentless grasp on many parts    of a patients life, and Bristol Myers Squibb is committed to    taking actions to address all aspects of care, from diagnosis    to survivorship. Because as a leader in cancer care, Bristol    Myers Squibb is working to empower all people with cancer to    have a better future.  
    OPDUALAG U.S. INDICATION  
    Opdualag (nivolumab and relatlimab-rmbw) is indicated    for the treatment of adult and pediatric patients 12 years of    age or older with unresectable or metastatic melanoma.  
    OPDUALAG IMPORTANT SAFETY    INFORMATION  
    Severe and Fatal Immune-Mediated Adverse Reactions  
    Immune-mediated adverse reactions (IMARs) listed herein may not    include all possible severe and fatal immune-mediated adverse    reactions.  
    IMARs which may be severe or fatal, can occur in any organ    system or tissue. IMARs can occur at any time after starting    treatment with a LAG-3 and PD-1/PD-L1 blocking antibodies.    While IMARs usually manifest during treatment, they can also    occur after discontinuation of Opdualag. Early identification    and management of IMARs are essential to ensure safe use.    Monitor patients closely for symptoms and signs that may be    clinical manifestations of underlying IMARs. Evaluate clinical    chemistries including liver enzymes, creatinine, and thyroid    function at baseline and periodically during treatment. In    cases of suspected IMARs, initiate appropriate workup to    exclude alternative etiologies, including infection. Institute    medical management promptly, including specialty consultation    as appropriate.  
    Withhold or permanently discontinue Opdualag depending on    severity (please see section 2 Dosage and Administration in the    accompanying Full Prescribing Information). In general, if    Opdualag requires interruption or discontinuation, administer    systemic corticosteroid therapy (1 to 2 mg/kg/day prednisone or    equivalent) until improvement to Grade 1 or less. Upon    improvement to Grade 1 or less, initiate corticosteroid taper    and continue to taper over at least 1 month. Consider    administration of other systemic immunosuppressants in patients    whose IMARs are not controlled with corticosteroid therapy.    Toxicity management guidelines for adverse reactions that do    not necessarily require systemic steroids (e.g.,    endocrinopathies and dermatologic reactions) are discussed    below.  
    Immune-Mediated Pneumonitis  
    Opdualag can cause immune-mediated pneumonitis, which may be    fatal. In patients treated with other PD-1/PD-L1 blocking    antibodies, the incidence of pneumonitis is higher in patients    who have received prior thoracic radiation. Immune-mediated    pneumonitis occurred in 3.7% (13/355) of patients receiving    Opdualag, including Grade 3 (0.6%), and Grade 2 (2.3%) adverse    reactions. Pneumonitis led to permanent discontinuation of    Opdualag in 0.8% and withholding of Opdualag in 1.4% of    patients.  
    Immune-Mediated Colitis  
    Opdualag can cause immune-mediated colitis, defined as    requiring use of corticosteroids and no clear alternate    etiology. A common symptom included in the definition of    colitis was diarrhea. Cytomegalovirus infection/reactivation    has been reported in patients with corticosteroid-refractory    immune-mediated colitis. In cases of corticosteroid-refractory    colitis, consider repeating infectious workup to exclude    alternative etiologies.  
    Immune-mediated diarrhea or colitis occurred in 7% (24/355) of    patients receiving Opdualag, including Grade 3 (1.1%) and Grade    2 (4.5%) adverse reactions. Colitis led to permanent    discontinuation of Opdualag in 2% and withholding of Opdualag    in 2.8% of patients.  
    Immune-Mediated Hepatitis  
    Opdualag can cause immune-mediated hepatitis, defined as    requiring the use of corticosteroids and no clear alternate    etiology.  
    Immune-mediated hepatitis occurred in 6% (20/355) of patients    receiving Opdualag, including Grade 4 (0.6%), Grade 3 (3.4%),    and Grade 2 (1.4%) adverse reactions. Hepatitis led to    permanent discontinuation of Opdualag in 1.7% and withholding    of Opdualag in 2.3% of patients.  
    Immune-Mediated Endocrinopathies  
    Opdualag can cause primary or secondary adrenal insufficiency,    hypophysitis, thyroid disorders, and Type 1 diabetes mellitus,    which can be present with diabetic ketoacidosis. Withhold or    permanently discontinue Opdualag depending on severity (please    see section 2 Dosage and Administration in the accompanying    Full Prescribing Information).  
    For Grade 2 or higher adrenal insufficiency, initiate    symptomatic treatment, including hormone replacement as    clinically indicated. In patients receiving Opdualag, adrenal    insufficiency occurred in 4.2% (15/355) of patients receiving    Opdualag, including Grade 3 (1.4%) and Grade 2 (2.5%) adverse    reactions. Adrenal insufficiency led to permanent    discontinuation of Opdualag in 1.1% and withholding of Opdualag    in 0.8% of patients.  
    Hypophysitis can present with acute symptoms associated with    mass effect such as headache, photophobia, or visual field    defects. Hypophysitis can cause hypopituitarism; initiate    hormone replacement as clinically indicated. Hypophysitis    occurred in 2.5% (9/355) of patients receiving Opdualag,    including Grade 3 (0.3%) and Grade 2 (1.4%) adverse reactions.    Hypophysitis led to permanent discontinuation of Opdualag in    0.3% and withholding of Opdualag in 0.6% of patients.  
    Thyroiditis can present with or without endocrinopathy.    Hypothyroidism can follow hyperthyroidism; initiate hormone    replacement or medical management as clinically indicated.    Thyroiditis occurred in 2.8% (10/355) of patients receiving    Opdualag, including Grade 2 (1.1%) adverse reactions.    Thyroiditis did not lead to permanent discontinuation of    Opdualag. Thyroiditis led to withholding of Opdualag in 0.3% of    patients. Hyperthyroidism occurred in 6% (22/355) of patients    receiving Opdualag, including Grade 2 (1.4%) adverse reactions.    Hyperthyroidism did not lead to permanent discontinuation of    Opdualag. Hyperthyroidism led to withholding of Opdualag in    0.3% of patients. Hypothyroidism occurred in 17% (59/355) of    patients receiving Opdualag, including Grade 2 (11%) adverse    reactions. Hypothyroidism led to the permanent discontinuation    of Opdualag in 0.3% and withholding of Opdualag in 2.5% of    patients.  
    Monitor patients for hyperglycemia or other signs and symptoms    of diabetes; initiate treatment with insulin as clinically    indicated. Diabetes occurred in 0.3% (1/355) of patients    receiving Opdualag, a Grade 3 (0.3%) adverse reaction, and no    cases of diabetic ketoacidosis. Diabetes did not lead to the    permanent discontinuation or withholding of Opdualag in any    patient.  
    Immune-Mediated Nephritis with Renal    Dysfunction  
    Opdualag can cause immune-mediated nephritis, which is defined    as requiring use of steroids and no clear etiology. In patients    receiving Opdualag, immune-mediated nephritis and renal    dysfunction occurred in 2% (7/355) of patients, including Grade    3 (1.1%) and Grade 2 (0.8%) adverse reactions. Immune-mediated    nephritis and renal dysfunction led to permanent    discontinuation of Opdualag in 0.8% and withholding of Opdualag    in 0.6% of patients.  
    Withhold or permanently discontinue Opdualag depending on    severity (please see section 2 Dosage and Administration in the    accompanying Full Prescribing Information).  
    Immune-Mediated Dermatologic Adverse    Reactions  
    Opdualag can cause immune-mediated rash or dermatitis, defined    as requiring use of steroids and no clear alternate etiology.    Exfoliative dermatitis, including Stevens-Johnson syndrome,    toxic epidermal necrolysis, and Drug Rash with eosinophilia and    systemic symptoms has occurred with PD-1/L-1 blocking    antibodies. Topical emollients and/or topical corticosteroids    may be adequate to treat mild to moderate non-exfoliative    rashes.  
    Withhold or permanently discontinue Opdualag depending on    severity (please see section 2 Dosage and Administration in the    accompanying Full Prescribing Information).  
    Immune-mediated rash occurred in 9% (33/355) of patients,    including Grade 3 (0.6%) and Grade 2 (3.4%) adverse reactions.    Immune-mediated rash did not lead to permanent discontinuation    of Opdualag. Immune-mediated rash led to withholding of    Opdualag in 1.4% of patients.  
    Immune-Mediated Myocarditis  
    Opdualag can cause immune-mediated myocarditis, which is    defined as requiring use of steroids and no clear alternate    etiology. The diagnosis of immune-mediated myocarditis requires    a high index of suspicion. Patients with cardiac or    cardio-pulmonary symptoms should be assessed for potential    myocarditis. If myocarditis is suspected, withhold dose,    promptly initiate high dose steroids (prednisone or    methylprednisolone 1 to 2 mg/kg/day) and promptly arrange    cardiology consultation with diagnostic workup. If clinically    confirmed, permanently discontinue Opdualag for Grade 2-4    myocarditis.  
    Myocarditis occurred in 1.7% (6/355) of patients receiving    Opdualag, including Grade 3 (0.6%), and Grade 2 (1.1%) adverse    reactions. Myocarditis led to permanent discontinuation of    Opdualag in 1.7% of patients.  
    Other Immune-Mediated Adverse    Reactions  
    The following clinically significant IMARs occurred at an    incidence of <1% (unless otherwise noted) in patients who    received Opdualag or were reported with the use of other    PD-1/PD-L1 blocking antibodies. Severe or fatal cases have been    reported for some of these adverse reactions:    Cardiac/Vascular: pericarditis, vasculitis; Nervous    System: meningitis, encephalitis, myelitis and    demyelination, myasthenic syndrome/myasthenia gravis (including    exacerbation), Guillain-Barr syndrome, nerve paresis,    autoimmune neuropathy; Ocular: uveitis, iritis, and    other ocular inflammatory toxicities can occur. Some cases can    be associated with retinal detachment. Various grades of visual    impairment, including blindness, can occur. If uveitis occurs    in combination with other IMARs, consider a    Vogt-Koyanagi-Haradalike syndrome, as this may require    treatment with systemic steroids to reduce the risk of    permanent vision loss; Gastrointestinal: pancreatitis    including increases in serum amylase and lipase levels,    gastritis, duodenitis; Musculoskeletal and Connective    Tissue: myositis/polymyositis, rhabdomyolysis (and    associated sequelae including renal failure), arthritis,    polymyalgia rheumatica; Endocrine: hypoparathyroidism;    Other (Hematologic/Immune): hemolytic anemia, aplastic    anemia, hemophagocytic lymphohistiocytosis, systemic    inflammatory response syndrome, histiocytic necrotizing    lymphadenitis (Kikuchi lymphadenitis), sarcoidosis, immune    thrombocytopenic purpura, solid organ transplant rejection.  
    Infusion-Related Reactions  
    Opdualag can cause severe infusion-related reactions.    Discontinue Opdualag in patients with severe or    life-threatening infusion-related reactions. Interrupt or slow    the rate of infusion in patients with mild to moderate    infusion-related reactions. In patients who received Opdualag    as a 60-minute intravenous infusion, infusion-related reactions    occurred in 7% (23/355) of patients.  
    Complications of Allogeneic Hematopoietic Stem Cell    Transplantation (HSCT)  
    Fatal and other serious complications can occur in patients who    receive allogeneic hematopoietic stem cell transplantation    (HSCT) before or after being treated with a PD-1/PD-L1 receptor    blocking antibody. Transplant-related complications include    hyperacute graft-versus-host disease (GVHD), acute GVHD,    chronic GVHD, hepatic veno-occlusive disease after reduced    intensity conditioning, and steroid-requiring febrile syndrome    (without an identified infectious cause). These complications    may occur despite intervening therapy between PD-1/PD-L1    blockade and allogeneic HSCT.  
    Follow patients closely for evidence of transplant-related    complications and intervene promptly. Consider the benefit    versus risks of treatment with a PD-1/PD-L1 receptor blocking    antibody prior to or after an allogeneic HSCT.  
    Embryo-Fetal Toxicity  
    Based on its mechanism of action and data from animal studies,    Opdualag can cause fetal harm when administered to a pregnant    woman. Advise pregnant women of the potential risk to a fetus.    Advise females of reproductive potential to use effective    contraception during treatment with Opdualag for at least 5    months after the last dose of Opdualag.  
    Lactation  
    There are no data on the presence of Opdualag in human milk,    the effects on the breastfed child, or the effect on milk    production. Because nivolumab and relatlimab may be excreted in    human milk and because of the potential for serious adverse    reactions in a breastfed child, advise patients not to    breastfeed during treatment with Opdualag and for at least 5    months after the last dose.  
    Serious Adverse Reactions  
    In Relativity-047, fatal adverse reaction occurred in 3 (0.8%)    patients who were treated with Opdualag; these included    hemophagocytic lymphohistiocytosis, acute edema of the lung,    and pneumonitis. Serious adverse reactions occurred in 36% of    patients treated with Opdualag. The most frequent serious    adverse reactions reported in 1% of patients treated with    Opdualag were adrenal insufficiency (1.4%), anemia (1.4%),    colitis (1.4%), pneumonia (1.4%), acute myocardial infarction    (1.1%), back pain (1.1%), diarrhea (1.1%), myocarditis (1.1%),    and pneumonitis (1.1%).  
    Common Adverse Reactions and Laboratory Abnormalities  
    The most common adverse reactions reported in 20% of the    patients treated with Opdualag were musculoskeletal pain (45%),    fatigue (39%), rash (28%), pruritus (25%), and diarrhea (24%).  
    The most common laboratory abnormalities that occurred in 20%    of patients treated with Opdualag were decreased hemoglobin    (37%), decreased lymphocytes (32%), increased AST (30%),    increased ALT (26%), and decreased sodium (24%).  
    Please see U.S. Full Prescribing Information for OPDUALAG.  
    OPDIVO U.S. INDICATIONS  
    OPDIVO (nivolumab), as a single agent, is indicated    for the treatment of adult patients with unresectable or    metastatic melanoma.  
    OPDIVO (nivolumab), in combination with    YERVOY (ipilimumab), is indicated for the treatment    of adult patients with unresectable or metastatic melanoma.  
    OPDIVO (nivolumab) is indicated for the adjuvant    treatment of adult patients with melanoma with involvement of    lymph nodes or metastatic disease who have undergone complete    resection.  
    OPDIVO (nivolumab), in combination with    platinum-doublet chemotherapy, is indicated as neoadjuvant    treatment of adult patients with resectable (tumors 4 cm or    node positive) non-small cell lung cancer (NSCLC).  
    OPDIVO (nivolumab), in combination with    YERVOY (ipilimumab), is indicated for the    first-line treatment of adult patients with metastatic    non-small cell lung cancer (NSCLC) whose tumors express PD-L1    (1%) as determined by an FDA-approved test, with no EGFR or    ALK genomic tumor aberrations.  
    OPDIVO (nivolumab), in combination with    YERVOY (ipilimumab) and 2 cycles of    platinum-doublet chemotherapy, is indicated for the first-line    treatment of adult patients with metastatic or recurrent    non-small cell lung cancer (NSCLC), with no EGFR or ALK genomic    tumor aberrations.  
    OPDIVO (nivolumab) is indicated for the treatment    of adult patients with metastatic non-small cell lung cancer    (NSCLC) with progression on or after platinum-based    chemotherapy. Patients with EGFR or ALK genomic tumor    aberrations should have disease progression on FDA-approved    therapy for these aberrations prior to receiving OPDIVO.  
    OPDIVO (nivolumab), in combination with    YERVOY (ipilimumab), is indicated for the    first-line treatment of adult patients with unresectable    malignant pleural mesothelioma (MPM).  
    OPDIVO (nivolumab), in combination with    YERVOY (ipilimumab), is indicated for the    first-line treatment of adult patients with intermediate or    poor risk advanced renal cell carcinoma (RCC).  
    OPDIVO (nivolumab), in combination with    cabozantinib, is indicated for the first-line treatment of    adult patients with advanced renal cell carcinoma (RCC).  
    OPDIVO (nivolumab) is indicated for the treatment    of adult patients with advanced renal cell carcinoma (RCC) who    have received prior anti-angiogenic therapy.  
    OPDIVO (nivolumab) is indicated for the treatment    of adult patients with classical Hodgkin lymphoma (cHL) that    has relapsed or progressed after autologous hematopoietic stem    cell transplantation (HSCT) and brentuximab vedotin or after 3    or more lines of systemic therapy that includes autologous    HSCT. This indication is approved under accelerated approval    based on overall response rate. Continued approval for this    indication may be contingent upon verification and description    of clinical benefit in confirmatory trials.  
    OPDIVO (nivolumab) is indicated for the treatment    of adult patients with recurrent or metastatic squamous cell    carcinoma of the head and neck (SCCHN) with disease progression    on or after platinum-based therapy.  
    OPDIVO (nivolumab) is indicated for the treatment    of adult patients with locally advanced or metastatic    urothelial carcinoma who have disease progression during or    following platinum-containing chemotherapy or have disease    progression within 12 months of neoadjuvant or adjuvant    treatment with platinum-containing chemotherapy.  
    OPDIVO (nivolumab), as a single agent, is indicated    for the adjuvant treatment of adult patients with urothelial    carcinoma (UC) who are at high risk of recurrence after    undergoing radical resection of UC.  
    OPDIVO (nivolumab), as a single agent, is indicated    for the treatment of adult and pediatric (12 years and older)    patients with microsatellite instability-high (MSI-H) or    mismatch repair deficient (dMMR) metastatic colorectal cancer    (CRC) that has progressed following treatment with a    fluoropyrimidine, oxaliplatin, and irinotecan. 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 confirmatory trials.  
    OPDIVO (nivolumab), in combination with    YERVOY (ipilimumab), is indicated for the treatment    of adults and pediatric patients 12 years and older with    microsatellite instability-high (MSI-H) or mismatch repair    deficient (dMMR) metastatic colorectal cancer (CRC) that has    progressed following treatment with a fluoropyrimidine,    oxaliplatin, and irinotecan. 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 confirmatory trials.  
    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.  
    IMPORTANT SAFETY    INFORMATION  
    Severe and Fatal Immune-Mediated Adverse Reactions  
    Immune-mediated adverse reactions listed herein may not include    all possible severe and fatal immune-mediated adverse    reactions.  
    Immune-mediated adverse reactions, which may be severe or    fatal, can occur in any organ system or tissue. While    immune-mediated adverse reactions usually manifest during    treatment, they can also occur after discontinuation of OPDIVO    or YERVOY. Early identification and management are essential to    ensure safe use of OPDIVO and YERVOY. Monitor for signs and    symptoms that may be clinical manifestations of underlying    immune-mediated adverse reactions. Evaluate clinical    chemistries including liver enzymes, creatinine,    adrenocorticotropic hormone (ACTH) level, and thyroid function    at baseline and periodically during treatment with OPDIVO and    before each dose of YERVOY. In cases of suspected    immune-mediated adverse reactions, initiate appropriate workup    to exclude alternative etiologies, including infection.    Institute medical management promptly, including specialty    consultation as appropriate.  
    Withhold or permanently discontinue OPDIVO and YERVOY depending    on severity (please see section 2 Dosage and Administration in    the accompanying Full Prescribing Information). In general, if    OPDIVO or YERVOY interruption or discontinuation is required,    administer systemic corticosteroid therapy (1 to 2 mg/kg/day    prednisone or equivalent) until improvement to Grade 1 or less.    Upon improvement to Grade 1 or less, initiate corticosteroid    taper and continue to taper over at least 1 month. Consider    administration of other systemic immunosuppressants in patients    whose immune-mediated adverse reactions are not controlled with    corticosteroid therapy. Toxicity management guidelines for    adverse reactions that do not necessarily require systemic    steroids (e.g., endocrinopathies and dermatologic reactions)    are discussed below.  
    Immune-Mediated Pneumonitis  
    OPDIVO and YERVOY can cause immune-mediated pneumonitis. The    incidence of pneumonitis is higher in patients who have    received prior thoracic radiation. In patients receiving OPDIVO    monotherapy, immune-mediated pneumonitis occurred in 3.1%    (61/1994) of patients, including Grade 4 (<0.1%), Grade 3    (0.9%), and Grade 2 (2.1%). In patients receiving OPDIVO 1    mg/kg with YERVOY 3 mg/kg every 3 weeks, immune-mediated    pneumonitis occurred in 7% (31/456) of patients, including    Grade 4 (0.2%), Grade 3 (2.0%), and Grade 2 (4.4%). In patients    receiving OPDIVO 3 mg/kg with YERVOY 1 mg/kg every 3 weeks,    immune-mediated pneumonitis occurred in 3.9% (26/666) of    patients, including Grade 3 (1.4%) and Grade 2 (2.6%). In NSCLC    patients receiving OPDIVO 3 mg/kg every 2 weeks with YERVOY 1    mg/kg every 6 weeks, immune-mediated pneumonitis occurred in 9%    (50/576) of patients, including Grade 4 (0.5%), Grade 3 (3.5%),    and Grade 2 (4.0%). Four patients (0.7%) died due to    pneumonitis.  
    In Checkmate 205 and 039, pneumonitis, including interstitial    lung disease, occurred in 6.0% (16/266) of patients receiving    OPDIVO. Immune-mediated pneumonitis occurred in 4.9% (13/266)    of patients receiving OPDIVO, including Grade 3 (n=1) and Grade    2 (n=12).  
    Immune-Mediated Colitis  
Original post:
Bristol Myers Squibb Receives European Commission Approval for LAG-3-Blocking Antibody Combination, Opdualag (nivolumab and relatlimab), for the...