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Trial Update on Tiragolumab Plus Atezolizumab as First-Line Treatment of NSCLC

By: Cordi Craig, MS
Posted: Monday, August 29, 2022

The combination of PD-1 or PD-L1 inhibitors with tiragolumab, a novel anti-TIGIT inhibitory immune checkpoint agent, may further amplify the targeted inhibition of the PD-L1–PD-1 pathway. Results of the randomized phase II CITYSCAPE trial, published in The Lancet Oncology, suggest that tiragolumab plus atezolizumab may be safe and effective for some patients with previously untreated, locally advanced, unresectable, or metastatic non–small cell lung cancer (NSCLC). Byoung Chul Cho, MD, of Yonsei University College of Medicine, Seoul, South Korea, and colleagues reported that this immunotherapy combination showed clinically meaningful improvement in outcomes in those with PD-L1–positive disease.

“The preliminary efficacy and safety of tiragolumab plus atezolizumab as a first-line treatment in patients with PD-L1 high NSCLC observed in this phase II study is being confirmed in an ongoing phase III study (SKYSCRAPER-01; ClinicalTrials.gov identifier NCT04294810),” the study authors concluded.

The study authors randomly assigned patients with chemotherapy-naive, PD-L1–positive, recurrent, or metastatic NSCLC on a 1:1 basis to receive tiragolumab plus atezolizumab (n = 67) or placebo plus atezolizumab (n = 68). After a median follow-up of 5.9 months, objective responses were nearly double among patients treated with tiragolumab plus atezolizumab (n = 21) compared with patients treated with placebo plus atezolizumab (n = 11; P = .031). The median progression-free survival was 5.4 months versus 3.6 months with the addition of tiragolumab versus placebo, respectively (P = .015).

Treatment-related adverse events were reported in 14 patients treated with tiragolumab plus atezolizumab and 12 patients treated with placebo plus atezolizumab. Lipase increase was the most frequently reported severe treatment-related adverse event; it was observed in six patients who received the addition of tiragolumab and two patients who received the addition of placebo. Treatment-related deaths (from pyrexia and infection) occurred in two patients treated with tiragolumab plus atezolizumab.

Disclosure: For full disclosures of the study authors, visit thelancet.com.


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