Martin Reck, MD, PhD
Treatment with the combination of atezolizumab (Tecentriq), bevacizumab (Avastin), carboplatin, and paclitaxel delayed progression or death by 38% compared with bevacizumab and chemotherapy alone for patients with advanced non-squamous non–small cell lung cancer (NSCLC), according to findings from the phase III IMpower150 trial presented at the ESMO Immuno Oncology Congress.
<.0001). The ORR in this group was 69% with atezolizumab compared with 54% without the PD-L1 inhibitor. The 12-month PFS rate was 18% with bevacizumab/chemotherapy and 46% with the addition of atezolizumab.
Each of the agents showed similar toxicity profiles as in previous trials. Serious treatment-related adverse events were observed in 25.4% of patients treated with the atezolizumab regimen compared with 19.3% of those in the control arm. "There were no new safety signals or toxicity issues with this combination so it appears to be a feasible approach for this group of patients," Reck noted.
Preliminary findings were also presented for the comparison of arm A (atezolizumab plus chemotherapy without bevacizumab) with the control arm of bevacizumab plus chemotherapy (arm C). In this analysis, there was not a benefit seen in PFS for atezolizumab (HR, 0.936; 95% CI, 0.787-1.112). Additionally, ORR was similar between the two groups (49% vs 48%). Data for this comparison continue to mature for OS.
“This Tecentriq study is the first positive Phase III combination trial that showed a cancer immunotherapy reduced the risk of the disease getting worse when used as an initial treatment in a broad group of people with advanced non-squamous NSCLC,” Sandra Horning, MD, chief medical officer and Head of Global Product Development at Roche, the company developing the drugs. “The IMpower150 study represents an important advance in lung cancer treatment, and we will submit these results to regulatory authorities around the world to potentially bring a new standard of care to people living with this disease as soon as possible.”
Atezolizumab is currently approved as a treatment for patients with metastatic NSCLC following progression on a platinum-containing regimen. For lung cancer, bevacizumab is approved for patients with non-squamous NSCLC in combination with carboplatin and paclitaxel.
Several studies continue to assess atezolizumab as a treatment for patients with lung cancer as part of various combinations or as monotherapy. The PD-L1 inhibitor is being looked at with nab-paclitaxel (Abraxane) and in combinations with pemetrexed and other chemotherapy agents. The combination of atezolizumab and bevacizumab is being assessed in several solid tumors, with promising findings presented in renal cell carcinoma. Trial looking at this combination are currently ongoing.
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.
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