Atezolizumab plus chemotherapy improves survival in lung cancer subtype
CHICAGO — The addition of atezolizumab to bevacizumab plus chemotherapy extended OS for patients with non-small cell lung cancer, according to updated phase 3 overall survival data from the IMpower150 study presented at the ASCO Annual Meeting.
Previous IMpower150 data showing an improvement in PFS was presented at the American Association for Cancer Research Annual Meeting.
In these updated IMpower 150 study results, Mark A. Socinski, MD, executive medical director of Florida Hospital Cancer Institute, and colleagues assessed the addition of atezolizumab in the first-line setting for 1,202 patients with stage 4 or recurrent metastatic nonsquamous NSCLC.
Researchers separated patients into three cohorts. Cohort A included patients who received atezolizumab (Tecentriq, Genentech) and chemotherapy (n =402). Cohort B, also known as the experimental arm, consisted of 400 patients who received atezolizumab plus chemotherapy and bevacizumab (Avastin, Genentech). Patients in cohort C, the control group, received chemotherapy plus bevacizumab (n = 400).
The median age for all cohorts was 63 years and each cohort were 60% male.
Patients were divided into either ITT wild-type (87%) or EGFR or ALK-positive (13%).
Investigator-assessed PFS and OS served as the primary endpoints; secondary endpoints included overall response rate and safety.
Researchers reported a median OS of 19.2 months (95% CI; 17-23.8) in patients from the experimental arm compared with patients in the control group which had a median OS of 14.7 months (95% CI; 13.3-16.9) (HR = 0.78; 95% CI, 0.64-0.96).
An interesting aspect of this trial was the results found in groups of interest, according to Socinski.
The addition of atezolizumab to chemotherapy and bevacizumab resulted in an OS of 13.2 months compared with 9.1 months in patients with liver metastases who received bevacizumab plus chemotherapy (HR = 0.54; 95% CI, 0.33-0.88).
“This suggests that the interplay between anti-VEGF therapy and anti-PD–L1 therapy is important in this subgroup of patients,” Socinski said during his presentation.
Socinski and colleagues also reported an increased median OS in patients who received atezolizumab plus chemotherapy and bevacizumab (19.8 months; 95% CI, 17.4-24.2) compared with bevacizumab and chemotherapy (14.9 months; 95% CI, 13.4-17.1).
Patients across all three cohorts reported a similar number of adverse events. All-grade treatment-related adverse events were reported in 94% of patients in cohorts A and B, and 96% of patients in cohort C.
Serious adverse events were reported in 39% of patients in cohort A, 44% of patients in cohort B and 34% of patients in cohort C.
The most common all-grade adverse events across all three cohorts included rash and hepatitis.
Thirteen percent of patients within cohort A had to stop any treatment as a result of an adverse event, while 34% of patients in cohort B and 25% of patients in cohort C had to stop any treatment.
“These data demonstrate that the combination of atezolizumab plus bevacizumab and chemotherapy provide a new standard of care,” he said. – by Ryan McDonald
Socinski MA, et al. Abstract 9002. Presented at: ASCO Annual Meeting; June 1-5, 2018; Chicago.
Disclosures: Socinski reports honoraria from AstraZeneca, Bristol-Myers Squibb, Celgene and Genentech; consulting or advisory with Genentech; speakers’ bureau with AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb and Genentech; and research funding from Genentech.