Dr. Wakelee on First Trial to Combine Antiangiogenic Agents With Immunotherapy in NSCLC

Heather A. Wakelee, MD, medical oncologist, thoracic specialist, professor of medicine at Stanford University, discusses results from the phase III IMpower150 trial in non—small cell lung cancer (NSCLC).

In the phase III IMpower150 trial, patients with metastatic disease were randomly assigned 1:1:1 to receive either atezolizumab (Tecentriq) plus bevacizumab (Avastin) and carboplatin/paclitaxel (ABCP); atezolizumab plus carboplatin/paclitaxel (ACP); or bevacizumab plus carboplatin/paclitaxel (BCP). This trial is the first to combine antiangiogenic agents with immunotherapy, says Wakelee. Results showed improved progression-free survival and overall survival (OS) with the four-drug regimen in all-comers, but also in those with EGFR mutations. Although the OS benefit wasn’t statistically significant in those patients, it was impressive, she adds.

Wakelee believes more studies investigating the role of antiangiogenic agents in combination with chemotherapy and immunotherapy are needed. Potential areas for further research include combination of antiangiogenic agents with different chemotherapies, further exploration into bevacizumab and ramucirumab (Cyramza) and their role in the treatment of this patient subset, and the addition or removal of VEGF inhibitors with antiangiogenic agents, concludes Wakelee.