Atezolizumab Combo Improves Survival in Non–Small Cell Lung Cancer

Data revealed at ASCO shows combination of atezolizumab (Tecentriq), bevacizumab (Avastin), carboplatin, and paclitaxel reduced the risk of death by 22% compared with bevacizumab and chemotherapy.

The combination of atezolizumab (Tecentriq), bevacizumab (Avastin), carboplatin, and paclitaxel (ABCP) reduced the risk of death by 22% compared with bevacizumab and chemotherapy (BCP) in patients with advanced wild-type non-squamous non—small cell lung cancer (NSCLC), according to phase III data from the IMpower150 trial presented at the 2018 ASCO Congress and published in the New England Journal of Medicine.1,2

The median overall survival (OS) with the addition of the PD-L1 inhibitor atezolizumab was 19.2 months (95% CI, 17.0-23.8) compared with 14.7 months (95% CI, 13.3-16.9) in the BCP arm (HR, 0.78; 95% CI, 0.64-0.96; P = .0164). The 24-month OS rate with atezolizumab was 43% compared with 34% for BCP. ABCP also improved median progression-free survival (PFS) by 1.5 months compared with BCP (8.3 vs 6.8 months; HR, 0.59; 95% CI, 0.50-0.70; P <.0001).

"The IMpower150 trial met its co-primary PFS and OS endpoints and demonstrated a statistically significant and clinically meaningful benefit with atezolizumab plus bevacizumab and chemotherapy versus bevacizumab and chemotherapy alone in the first-line nonsquamous NSCLC setting, across all PD-L1 subgroups," said lead investigator Mark A. Socinski, MD, executive medical director of the Florida Hospital Cancer Institute. "In the landmark analysis, you see an approximate doubling in median PFS and a tripling in the 18-month progression-free rate."

The trial was designed to exclude data for patients with EGFR/ALK-mutated NSCLC from the co-primary endpoints of OS and PFS. Approximately 13% of the trials participants were EGFR or ALK-positive. Prior to study entry, these patients had received at least 1 prior EGFR TKI.

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