Data from IMpower 130, IMpower 132, and IMpower 150 confirm that combining atezolizumab with chemotherapy is the best first-line treatment in advanced NSCLC when anti-PD-L1 therapy is indicated.
The rise of immunotherapy in cancer care has brought with it the challenge of managing adverse events (AEs). But immune-related AEs are known to be a sign that the treatment is working, and an pooled analysis of phase 3 trials involved atezolizumab (Tecentriq), presented during the 2021 American Society of Clinical Oncology Annual Meeting, show that the presence of low-grade AEs can, in fact, predict longer overall survival (OS).
Atezolizumab is currently approved in the first- and second-line settings for advanced non-small cell lung cancer (NSCLC). In an exploratory analysis, investigators pooled data from the IMpower 130, the IMpower 132, and the IMpower 150 studies, which evaluated the anti-PD-L1 agent in various combinations in treatment-naïve patients with nonsquamous stage IV NSCLC. The combinations were:
Analyses of immune-related AEs and survival took place at 1, 3, 6, and 12 months. In total, 2503 patients were included; 1577 in the atezolizumab arm and 926 in the control arm. Study protocols called for treatment interruption or discontinuation of AEs were grade 3 or higher.
The authors concluded that patients with grade 1 and 2 immune-related AEs had the longest OS and those with grade 3 or higher had the shortest, possibly due to discontinuation of therapy. They wrote that the data offer additional support for atezolizumab with chemotherapy in the first-line setting, with or without bevacizumab.
F. Hoffman-LaRoche funded the study.
Socinski MA, Jotte RM, Cappuzzo F, et al. Pooled analyses of immune-related adverse events (irAEs) and efficacy from thephase 3 trials IMpower130, IMpower132, and IMpower150. J Clin Oncol. 2021; 39(Suppl_15): abstr 9002. DOI: 10.1200/JCO.2021.39.15_suppl.9002