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Gregory J. Riely, MD, PhD
Gregory J. Riely, MD, PhD
Posted: Tuesday, February 22, 2022
According to the findings from the IMpower010 trial published in The Lancet, patients with resected early-stage non–small cell lung cancer (NSCLC) who underwent atezolizumab treatment experienced superior disease-free survival outcomes versus those who received best supportive care after adjuvant platinum-based chemotherapy. Heather Wakelee, MD, of the Stanford Cancer Institute, California, and colleagues noted this benefit was pronounced in a subgroup of patients whose tumors expressed PD-L1 in at least 1% of cells.
The phase III study enrolled 1,280 patients across 22 countries and regions between October 7, 2015, and September 19, 2018. Participants had completely resected stage IB to IIIA tumors. Following adjuvant platinum-based chemotherapy, 1,005 eligible patients were randomly assigned to receive either 1,200 mg of adjuvant atezolizumab every 21 days for 16 cycles or 1 year (n = 507) or best supportive care consisting of observation and routine scans (n = 498). A total of 495 patients in each arm received the assigned treatment.
The median follow-up was 32.2 months. Among patients with stage II to IIIA disease whose tumors expressed PD-L1 in at least 1% of cells, disease-free survival was superior with atezolizumab compared with best supportive care; this finding also appeared to hold true in all patients with stage II to IIIA NSCLC. The disease-free survival hazard ratio was 0.81 among the intent-to-treat population. Of the patients treated with atezolizumab, 11% experienced grade 3 or 4 treatment-related adverse events, and 1% experienced a grade 5 event.
“Atezolizumab after adjuvant chemotherapy offers a promising treatment option for patients with resected early-stage NSCLC,” concluded the authors.
Disclosure: For full disclosures of the study authors, visit thelancet.com.
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