Atezolizumab boosts survival in NSCLC subgroups

  • Reck M & al.
  • Lancet Respir Med
  • 25 Mar 2019

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • Adding atezolizumab to standard bevacizumab plus carboplatin plus paclitaxel (ABCP) offered better OS and PFS in patients with chemotherapy-naive NSCLC and sensitizing epidermal growth factor receptor (EGFR) mutations or baseline liver metastases.

Why this matters

  • This therapy might be an option for these patient subgroups, especially those with sensitizing EGFR mutations who have progressed on tyrosine kinase inhibitor therapy.

Study design

  • Randomized, open-label, international, phase 3 IMpower150 trial.
  • 1202 patients with chemotherapy-naive metastatic NSCLC received ABCP (n=400), ACP (n=402), or BCP (n=400).
  • Funding: F. Hoffmann-La Roche, Genentech.

Key results

  • ABCP yielded better OS than BCP in:
    • Patients with sensitizing EGFR mutations (HR, 0.31; 95% CI, 0.11-0.83);
    • Patients with baseline liver metastases (HR, 0.52; 95% CI, 0.33-0.82).
  • ABCP yielded better PFS than BCP in:
    • Patients with sensitizing EGFR mutations (HR, 0.41; 95% CI, 0.23-0.75);
    • Patients with baseline liver metastases (HR, 0.41; 95% CI, 0.26-0.62).
  • No improvement in OS with ACP compared with BCP.
  • Grade 3-5 adverse events were slightly higher in ABCP group compared with the other groups.

Limitations

  • Small subgroup sample sizes.

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