Study: Immunotherapy Delays Recurrence in Patients with Early-Stage, Resected NSCLC

The objective of the study was to determine whether atezolizumab could also be efficacious for patients with earlier-stage disease who may be at risk of disease recurrence following surgery

The results of new research show that treatment with the immunotherapy atezolizumab (Tecentriq) extended disease-free survival (DFS) in patients with resected, early-stage non-small cell lung cancer (NSCLC), specifically in those positive for the immune checkpoint protein programmed death-ligand 1 (PD-L1), according to an upcoming presentation at the 2021 American Society of Clinical Oncology (ASCO) Annual Meeting.

The objective of the study was to determine whether atezolizumab could also be efficacious for patients with earlier-stage disease who may be at risk of disease recurrence following surgery, according to the study.

In the study, 1280 patients with completely resected stage IB-3A NSCLC were enrolled, and following cisplatin-based chemotherapy, 1005 patients were randomized to receive atezolizumab or best supportive care.

The findings showed that among patients with stage II to IIIA and levels of the immune checkpoint protein PD-L1 of at least 1%, the median DFS with atezolizumab had not yet been reached at data cut-off.

Further, the median DFS for best standard care was 35.3 months, according to the study authors.

Among all patients with stage II and IIIA NSCLC, median DFS was 42.3 months with atezolizumab and 35.3 months with best supportive care.

Adverse events of any grade occurred in 92.7% and 70.7% in the atezolizumab and best supportive care groups, respectively. In addition, more grade 3/4 adverse events were seen in those that received immunotherapy compared with best supportive care -21.8% and 11.5%.

Approximately 20% of those in the atezolizumab arm experienced adverse effects that caused them to discontinue treatment, according to the study authors.

“Though surgery can cure some patients with early-stage lung cancer, disease recurrence is still very common. Until this trial, the only treatment that was known to help reduce that risk for most patients was chemotherapy [or osimertinib for the small group of patients with tumors with an EGFR mutation],” said lead author Heather Wakelee, MD, a thoracic specialist and professor of medicine and chief of the Division of Oncology at the Stanford University Medical Center in California. “These data show that personalized medicine with atezolizumab can reduce the chance of NSCLC returning after surgery for patients who have a tumor that expresses the biomarker PD-L1.”

REFERENCE

Immunotherapy delays disease recurrence in patients with early-stage, resected non-small cell lung cancer. American Society of Clinical Oncology. May 19, 2021. Accessed May 24, 2021. https://www.asco.org/about-asco/press-center/news-releases/immunotherapy-delays-disease-recurrence-patients-early-stage?cid=DM7637&bid=80018089