Bob T. Li, MD, PhD, MPH, discusses the limitations of the phase 3 IMpower010 trial in resected stage IB to IIIA non–small cell lung cancer.
Bob T. Li, MD, PhD, MPH, medical oncologist, physician ambassador to China and Asia-Pacific, Bobst International Center, co-director, Thoracic Liquid Biopsy Program, chief scientific officer, MSK Direct, Memorial Sloan Kettering Cancer Center, discusses the limitations of the phase 3 IMpower010 trial (NCT02486718) in resected stage IB to IIIA non–small cell lung cancer (NSCLC).
The results of the IMpower010 study demonstrated a statistically significant improvement in disease-free survival with adjuvant atezolizumab (Tecentriq) vs best supportive care in patients with stage II to IIA NSCLC. On August 3, 2021, the FDA granted priority review to a supplemental biologics license application for atezolizumab after surgery and platinum-based chemotherapy in patients with NSCLC whose tumors have a PD-L1 expression of 1% or higher per an FDA-approved test. The application is supported by the results of the IMpower010 trial.
Although the potential approval is welcome in the treatment of patients with resected NSCLC, further investigation into the biomarker analysis of the study beyond PD-L1 expression is warranted, Li says. It is important to evaluate the blood plasma of patients to determine who was cured with surgery and who is likely to relapse. In the latter group, aggressive adjuvant treatment may be indicated, Li adds.
Moreover, more precise clinical trials with available technologies that evaluate the likelihood of cure vs relapse are needed to determine whether patients should receive more intensive adjuvant therapy, Li concludes.