IMpower130 Supports Atezolizumab Inclusion in Stage IV Lung Cancer Therapy
Posted: Monday, August 19, 2019
With more than 18 months of follow-up, the investigators of the IMpower130 trial have concluded that first-line treatment combining atezolizumab with carboplatin plus nab-paclitaxel chemotherapy significantly improves overall and progression-free survival over chemotherapy alone, in patients with metastatic, nonsquamous, wild-type non–small cell lung cancer (NSCLC). The results of the randomized phase III open-label trial, published in The Lancet Oncology and involving 131 sites in 8 countries, indicate that the benefits hold regardless of PD-L1 expression.
Howard West, MD, of the Swedish Cancer Institute in Seattle, and colleagues noted that median overall survival was 18.6 months in the atezolizumab group (451 patients) versus 13.9 months in the chemotherapy group (228 patients; stratified hazard ratio = 0.79; P = .033). The median progression-free survival was 7.0 months versus 5.5 months, respectively (stratified hazard ratio = 0.64; P < .0001).
Prior work showed that the monoclonal antibody atezolizumab improved overall survival in patients with previously treated NSCLC, wrote Dr. West and his co-investigators. All patients in IMpower130 had no ALK or EGFR mutation and had an Eastern Cooperative Oncology Group performance status of 0 or 1.
This work identified no new safety signals. “The most common grade ≥ 3 treatment-related adverse events were neutropenia (32% in the atezolizumab group vs. 28% in the chemotherapy group), anemia (29% vs. 20%), and decreased neutrophil count (12% vs. 8%),” described the team. “Treatment-related serious adverse events were reported in 24% versus 13% of patients.”
Disclosure: The study authors’ disclosure information may be found at thelancet.com.