Renal cancer: atezolizumab tops sunitinib for QoL

  • Pal SK & al.
  • BJU Int
  • 31 Mar 2020

  • curated by Deepa Koli
  • Univadis Clinical Summaries
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Takeaway

  • In treatment-naive patients with metastatic renal cell carcinoma (RCC), atezolizumab monotherapy is associated with milder disease- and treatment-related symptoms (including fatigue) and delayed symptom deterioration vs sunitinib.

Why this matters

  • Improvement in disease- and treatment-related symptoms in cancer is important in therapeutic decision making.

Study design

  • Patient-reported outcomes from the phase 2 IMmotion150 trial.
  • 305 untreated patients with metastatic RCC were randomly assigned to atezolizumab monotherapy (n=103), atezolizumab+bevacizumab (n=101), or sunitinib (n=101).
  • Funding: Memorial Sloan Kettering Cancer Center.

Key results

  • Atezolizumab monotherapy vs sunitinib was associated with significant improvement in the deterioration-free rate (HRs; 95% CIs) for:
    • MD Anderson Symptom Inventory (MDASI) core symptom severity: 0.39 (0.22-0.71).
    • MDASI RCC symptom severity: 0.22 (0.12-0.41).
    • MDASI symptom interference: 0.36 (0.22-0.58).
    • Brief fatigue inventory (BFI) fatigue severity: 0.48 (0.33-0.70).
    • BFI fatigue interference: 0.38 (0.24-0.60).
  • The differences in least-square mean change and corresponding effect size for atezolizumab monotherapy vs sunitinib were, respectively:
    • Core symptoms, −0.47 and −0.33.
    • RCC symptoms, −0.64 and −0.70.
    • Symptom interference, −0.80 and −0.36.
  • All 16 symptoms assessed for severity were milder with atezolizumab monotherapy vs sunitinib.
  • Atezolizumab+bevacizumab significantly improved RCC symptoms vs sunitinib: HR, 0.60 (95% CI, 0.38-0.94).

Limitations

  • Open-label.