ASCO 2019 — Neoadjuvant atezolizumab yields encouraging response in NSCLC


  • Hao Cheng, MD
  • Oncology Conference reports
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Takeaway

  • 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.

Study design

  • 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.

Key results

  • 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.

Limitations

  • Interim analysis, has not yet reached full intended accrual.

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