- Neoadjuvant atezolizumab monotherapy is well tolerated, and thus far has yielded an encouraging pathological response rate in patients with resectable NSCLC.
Why this matters
- Small pilot studies show a possible benefit of neoadjuvant immune checkpoint inhibitor therapy in early-stage NSCLC.
- Presented is the interim efficacy analysis, including biomarker data, of LCMC3, a phase 2 study of neoadjuvant atezolizumab in stage IB, II, IIIA, or selected IIIB resectable NSCLC.
- 77 patients who received neoadjuvant atezolizumab for resectable NSCLC were eligible for efficacy analysis.
- Primary endpoint: major pathologic response (MPR) at surgical resection, defined as 10% viable tumor cells, determined by pathology review.
- Funding: Genentech Inc.
- About half of patients were stage IIIA/IIIB and about half were PD-L1-negative.
- 15/77 (20%; 95% CI, 11%-30%) achieved MPR.
- 4/77 (5%) patients had a complete pathological response.
- Pathological regression was correlated with change in tumor size (ρ=0.43; P<.001>
- Pathological regression and MPR were weakly correlated with PD-L1 expression (ρ=−0.24; P=.04).
- MPR was not significantly associated with tumor mutation burden or specific gene alterations.
- Interim analysis, has not yet reached full intended accrual.