RCC: atezolizumab-bevacizumab improve survival in sarcomatoid tumors

  • Rini BI & et al.
  • Eur Urol
  • 9 Jul 2020

  • curated by Deepa Koli
  • Univadis Clinical Summaries
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Takeaway

  • Atezolizumab plus bevacizumab improved response and PFS in treatment-naive patients with metastatic renal cell carcinoma (RCC) with sarcomatoid features vs sunitinib in a prespecified subgroup analysis of the phase 3 IMmotion151 trial.

Why this matters

  • Patients with sarcomatoid RCC have a poor prognosis, and their disease shows limited responsiveness to inhibition of the vascular endothelial growth factor pathway.

Study design

  • A prespecified analysis of the randomized, phase 3 IMmotion151 trial.
  • 142 previously untreated patients with advanced or metastatic RCC with sarcomatoid features received either atezolizumab+bevacizumab (n=68) or sunitinib (n=74).
  • Funding: F Hoffmann-La Roche Ltd; Genentech Inc.

Key results

  • In patients with sarcomatoid features, atezolizumab+bevacizumab vs sunitinib improved:
    • Median PFS: 8.3 vs 5.3 months;
      • HR, 0.52 (95% CI, 0.34-0.79).
    • Objective response rate (ORR): 49% vs 14%.
  • In patients with programmed death-ligand 1-positive tumors with sarcomatoid features, atezolizumab+bevacizumab vs sunitinib improved:
    • Median PFS: 8.6 vs 5.6 months;
      • HR, 0.45 (95% CI, 0.26-0.77).
    • ORR: 56% vs 12%.
  • No new safety signals were reported.

Limitations

  • Small sample size.