ASCO 2021: Atezolizumab in Early-Stage Resected NSCLC After Chemotherapy
Posted: Thursday, May 20, 2021
In the IMpower010 trial, patients with resected stage II to IIIA non–small cell lung cancer (NSCLC) derived a disease-free survival benefit from treatment with the anti–PD-L1 antibody atezolizumab versus best supportive care after adjuvant platinum-based chemotherapy, with a 34% reduced risk of recurrence. The interim results of this phase III study, which were presented by Heather A. Wakelee, MD, of the Stanford University Medical Center, and colleagues in a presscast in advance of the 2021 American Society of Clinical Oncology (ASCO) Annual Meeting (Abstract 8500), revealed a safety profile of atezolizumab comparable to that shown in previous reports. Overall survival data, however, are not yet mature.
“For the first time, we are seeing that an immunotherapy is effective when used to treat early-stage lung cancer,” commented Julie Gralow, MD, Chief Medical Officer of ASCO, in an ASCO press release.
A total of 1,005 patients with completely resected stage IB to IIIA disease who received up to four cycles of cisplatin-based chemotherapy were randomly assigned in a 1:1 ratio to receive atezolizumab or best supportive care. In the intention-to-treat population, follow-up data were provided for a median of 32.8 months.
Compared with best supportive care, disease-free survival seemed to significantly improve with atezolizumab in the subgroup with stage II to IIIA disease who had 1% or higher tumor cell PD-L1 expression (P = .0039) and in all randomized stage II to IIIA populations (P = .0205). However, the significance boundary was not crossed in the intention-to-treat population (P = .0395). The study remains immature for overall survival analysis.
Patients were treated with a median of 16 doses of atezolizumab. More adverse events of any grade were reported with atezolizumab than with best supportive care (92.7% vs. 70.7%, respectively). Additionally, compared with best supportive care, grade 3 and 4 adverse events occurred at a higher rate with atezolizumab (21.8% vs. 11.5%, respectively). A total of 18.2% of patients who received atezolizumab discontinued treatment due to adverse events.
Disclosure: For full disclosures of the study authors, visit coi.asco.org.