Patients with an advanced type of lung cancer had a 38% lower risk of death or worsening disease when atezolizumab (Tecentriq) was added to their regimen of bevacizumab (Avastin) and chemotherapy in the phase 3 IMpower150 study, Genentech has announced.
The pivotal IMpower150 study compared treatment with atezolizumab and bevacizumab plus chemotherapy (carboplatin and paclitaxel) to treatment with bevacizumab and chemotherapy alone in people with previously untreated, advanced non-squamous, non–small-cell lung cancer (NSCLC). Among people who received all four medications, progression-free survival (PFS) was 8.3 months, compared with 6.8 months for the bevacizumab/chemotherapy group (hazard ratio [HR], 0.62; 95% confidence interval, 0.52–0.74; P < 0.0001), according to Genentech, which markets both Tecentriq and Avastin.
Importantly, a doubling of the 12-month landmark PFS rate was observed with the combination of atezolizumab and bevacizumab plus chemotherapy (37%) compared with bevacizumab and chemotherapy (18%). The overall response rate (ORR), a secondary endpoint in the study, was higher in people treated with atezolizumab and bevacizumab plus chemotherapy compared with bevacizumab and chemotherapy (64% versus 48%). The safety profile of the triple combination was consistent with the safety profiles of the individual medicines, and no new safety signals were identified with the combination.
The analysis of the co-primary PFS endpoint in IMpower150 was assessed in two populations: all randomized people without an ALK or EGFR genetic mutation (intention-to-treat wild-type, ITT-WT) and in a subgroup of people who had a specific biomarker (T-effector “Teff” gene signature expression, Teff-WT). IMpower150 met its PFS co-primary endpoint per study protocol for both populations assessed. In the Teff-WT population, the combination of atezolizumab and bevacizumab plus chemotherapy reduced the risk of disease worsening or death by 49% compared to bevacizumab and chemotherapy, with median PFS of 11.3 versus 6.8 months (HR, 0.51; 95% CI, 0.38–0.68; P < 0.0001).
“This Tecentriq study is the first positive phase 3 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,” said Sandra Horning, MD, Genentech chief medical officer and head of Global Product Development. “The IMpower150 study represents an important advance in lung cancer treatment.”
Early results from the co-primary endpoint of overall survival are encouraging but not yet fully mature.
Source: Genentech; December 6, 2017.