Immunotherapy Reduces Risk of Disease Progression, Death in Non-Squamous NSCLC

Submitted by onc_editor on Thu, 12/07/2017 - 13:38

A groundbreaking study demonstrated a 38% risk reduction of disease worsening or death for patients receiving an immunotherapy plus chemotherapy combination as initial treatment for advanced non-squamous non-small cell lung cancer (NSCLC).

Results of the study (IMpower150) will be presented today at the European Society for Medical Oncology (EMSO) Immuno Oncology Congress (December 7-10, 2017l; Geneva, Switzerland).

IMpower150 is a multicenter, open-label, randomized, controlled phase III study which evaluated the efficacy and safety of atezolizumab (Tecentriq) plus chemotherapy (carboplatin and paclitaxel) with or without bevacizumab (Avastin) in patients with stage IV or recurrent metastatic non-squamous NSCLC who had not been treated with chemotherapy for their advanced disease. A total of 1202 patients were enrolled, and those with ALK and EGFR mutations were excluded from the primary intention to treat analysis.

Patients were randomized (1:1:1) to receive atezolizumab plus chemotherapy (Arm A), atezolizumab and bevacizumab plus chemotherapy (Arm B), or bevacizumab plus chemotherapy (Arm C). The co-primary endpoints were progression-free survival (PFS)—as determined by the investigator using RECIST v1.1—and overall survival (OS).

Results of the study showed that patients in Arm B had a 38% reduced risk of PFS compared with those who received bevacizumab plus chemotherapy (median PFS, 8.3 vs 6.8 months, respectively; HR, 0.62; 95% CI, 0.52-0.74; P < .0001). A doubling of the landmark 12-month PFS rate was observed for patients in Arm B (37%) compared with those in Arm C (18%).

Additionally, researchers reported that the overall response rate was higher in patients in Arm B compared with those in Arm C (64% vs 48%, respectively). The safety profile of the atezolizumab and bevacizumab plus chemotherapy combination was consistent with prior safety profiles of the individual therapies.

“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,” commented Sandra Horning, MD, CMO and Head of Global Product Development, Genentech, in a press release (December 6, 2017). “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.”

A previous report of this study details the design and initial findings, but without complete and mature PFS and OS data.—Zachary Bessette

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