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Frontline Findings Put Fresh Focus on Immunotherapy in NSCLC

Silas Inman @silasinman
Published: Wednesday, Dec 20, 2017

When excluding those with the highest expression, a benefit was still observed with the atezolizumab combination. In those with TC/IC 0/1/2, the median PFS was 8.0 months with atezolizumab compared with 6.8 months in the control arm (HR, 0.68). Even in the negative group specifically (TC/IC0), there was a 23% reduction in the risk of death with atezolizumab (HR, 0.77; 95% CI, 0.61-0.99). "For these patients, I'd like to see the shape of the curves over time," she said.

In a preliminary examination of OS, there was a 22.5% reduction in the risk of death with the atezolizumab combination compared with bevacizumab and chemotherapy alone. After a minimum follow-up of 9.5 months, the median OS was 14.4 months (95% CI, 12.8-17.1) versus 19.2 months (95% CI, 16.8-26.1), in favor of the atezolizumab group (HR, 0.775; 95% CI, 0.619-0.970; P = .0262). The next OS analysis will take place in the first half of 2018.

"Only 45% of events for the survival curve had occurred, so it is still too early to look at that," said Peters. "We need more time but I hope that the curve will separate more over time, which will make it significant."

Atezolizumab continues to be assessed in other frontline combination strategies. A phase Ib study is looking at the PD-L1 inhibitor in combination with erlotinib (Tarceva) for EGFR-mutant NSCLC or alectinib (Alecensa) for ALK-mutant NSCLC (NCT02013219). Additionally, several studies in the IMpower development program are looking at atezolizumab with standard chemotherapy regimens (IMpower 130, 131, and 132).

References

  1. 1. Reck M. Primary PFS and safety analyses of a randomized Phase III study of carboplatin + paclitaxel +/− bevacizumab, with or without atezolizumab in 1L non-squamous metastatic NSCLC (IMpower150). Annals of Oncology. 2017;28(11). Abstract LBA1_PR.
  2. 1. Brahmer JR, Rodríguez-Abreu D, Robinson AG, et al. Updated analysis of KEYNOTE-024: pembrolizumab vs platinum-based chemotherapy for advanced NSCLC with PD-L1 TPS ≥50%. Presented at: the IASLC 18th World Conference on Lung Cancer; October 15-18; Yokohama, Japan. Abstract OA 17.06 (ID 9582).



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