2018 ASCO Annual Meeting!
Session: Lung Cancer—Non-Small Cell Metastatic
Type: Oral Abstract Session
Time: Monday June 4, 3:00 PM to 6:00 PM
Location: Hall B1
Overall survival (OS) analysis of IMpower150, a randomized Ph 3 study of atezolizumab (atezo) + chemotherapy (chemo) ± bevacizumab (bev) vs chemo + bev in 1L nonsquamous (NSQ) NSCLC.
Metastatic Non-Small Cell Lung Cancer
Lung Cancer—Non-Small Cell Metastatic
2018 ASCO Annual Meeting
J Clin Oncol 36, 2018 (suppl; abstr 9002)
Author(s): Mark A. Socinski, Robert M. Jotte, Federico Cappuzzo, Francisco Jorquera Orlandi, Daniil Stroyakovskiy, Naoyuki Nogami, Delvys Rodriguez-Abreu, Denis Moro-Sibilot, Christian A. Thomas, Fabrice Barlesi, Gene Grant Finley, Claudia Kelsch, Anthony Lee, Shelley Coleman, Yijing Shen, Marcin Kowanetz, Ariel Lopez-Chavez, Alan Sandler, Martin Reck; Florida Hospital Cancer Institute, Orlando, FL; Rocky Mountain Cancer Centers, Denver, CO; AUSL Romagna, Ravenna, Italy; Instituto Nacional del Torax, Santiago, Chile; Moscow City Oncology Hospital #62, Moscow, Russian Federation; Department of Thoracic Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan; Hospital Universitavio Insular De Gran Canaria, Las Palmas, Spain; Centre Hospitalier Universitaire de Grenoble, Grenoble, France; New England Cancer Specialists, Scarborough, ME; Hospital Nord Service Oncologie, Marseille, France; Allegheny Health Network Cancer Institute, Pittsburgh, PA; Genentech, Inc., South San Francisco, CA; Genentech, Inc, South San Francisco, CA; LungenClinic Grosshansdorf, German Center for Lung Research, Grosshansdorf, Germany
Background: Atezo (anti–PD-L1) inhibits PD-L1 to restore anticancer immunity; bev may enhance atezo efficacy by inhibiting VEGF immunosuppression and promoting T-cell tumor infiltration. IMpower150 is the first randomized Ph 3 trial evaluating atezo + chemo (carboplatin [C] + paclitaxel [P]) ± bev vs CP + bev in 1L NSQ NSCLC. PFS benefit was observed with atezo + CP + bev vs CP + bev regardless of PD-L1 expression. Here we present the IMpower150 interim OS results. Methods: 1202 patients (pts) received atezo 1200 mg + C AUC 6 + P 200 mg/m2 (Arm A) or atezo + CP + bev 15 mg/kg (Arm B) vs CP + bev (Arm C) IV q3w for 4 or 6 cycles per investigator (INV); then maintenance atezo, atezo + bev, or bev, respectively. Co-primary endpoints were INV-assessed PFS in the ITT-WT (EGFR/ALK WT) and in WT pts with expression of a tumor T-effector gene signature (Teff-high WT) and OS in the ITT-WT. Data cutoff: 1/22/2018. Results: 349, 359, and 337 ITT-WT pts were enrolled in Arms A, B, and C, respectively, with median age 63 y, 62% male, 85% current/previous smokers, and 42% ECOG PS 0. With 13.5 mo min FU, OS was improved in Arm B vs C (HR, 0.78 [95% CI: 0.64, 0.96]; P = 0.016) in the ITT-WT; populations of interest are shown in the Table. Arm A vs C OS HR was 0.88 (95% CI: 0.72, 1.08; P = 0.204). In all treated patients, Gr 3-4 treatment-related AEs occurred in 43%, 57%, and 49% of pts in Arms A, B, and C, respectively. Conclusions: IMpower150 showed a significant OS benefit with atezo + CP + bev vs CP + bev in 1L NSQ NSCLC, and no new safety signals were seen. Clinical trial information: NCT02366143 IC, tumor-infiltrating immune cells; NE, not estimable; TC, tumor cells. a WT excludes pts with EGFR or ALK genomic alterations. b Present at baseline. TC1/2/3 or IC1/2/3 = PD-L1+ ≥ 1% of TC or IC; TC0 and IC0 = PD-L1+ < 1% of TC and IC
|Population||No. of Pts||HR (95% CI)||mOS, mo|
|Arm B||Arm C|
|ITT-WTa||696||0.78 (0.64, 0.96)||19.2||14.7|
|ITT||800||0.76 (0.63, 0.93)||19.8||14.9|
|EGFR/ALK+||104||0.54 (0.29, 1.03)||NE||17.5|
|Liver metastasesb||94||0.54 (0.33, 0.88)||13.2||9.1|
|Subgroups in ITT-WT|
|TC1/2/3 or IC1/2/3||357||0.77 (0.58, 1.04)||22.5||16.4|
|TC0 and IC0||339||0.82 (0.62, 1.08)||17.1||14.1|
|Teff-high||285||0.83 (0.59, 1.17)||25.0||16.7|
|Teff-low||377||0.78 (0.60, 1.02)||17.6||14.3|
1. Pembrolizumab (pembro) versus platinum-based chemotherapy (chemo) as first-line therapy for advanced/metastatic NSCLC with a PD-L1 tumor proportion score (TPS) ≥ 1%: Open-label, phase 3 KEYNOTE-042 study.