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OAK Trial: Disease Progression With Atezolizumab vs Chemotherapy in NSCLC

By: Kayci Reyer
Posted: Monday, January 7, 2019

Research presented at the European Society for Medical Oncology Immuno-Oncology Congress 2018 (Abstract LBA1) found that rapid post-baseline disease progression in patients with non–small cell lung cancer (NASCL) is not more common with atezolizumab or anti–PD-L1 treatment than with chemotherapy. David R. Gandara, MD, of the University of California Davis Cancer Center in Sacramento, and colleagues evaluated data from the OAK trial, which showed a consistent benefit with atezolizumab over docetaxel across all subgroups defined by baseline factors associated with aggressive disease. These findings were also published in the Annals of Oncology.

The phase III OAK study included 850 patients with NSCLC in a second- or third-line setting and compared checkpoint inhibition between two arms: patients receiving atezolizumab and patients receiving chemotherapy with docetaxel. Similar numbers of patients in each treatment arm met the criteria for fast disease progression (44 with atezolizumab versus 41 with docetaxel), which was defined as an increase of at least 50% in the sum of the longest diameters (SLD) of tumors from baseline to first assessment or upon death due to disease progression.

Additionally, improved overall survival in the atezolizumab arm was observed in patients with early prior treatment progression (median 8.9 vs. 6.2 months), high lactate dehydrogenase levels (≥ 225 U/L; median 11 vs. 8.9 months), high SLD (≥ 80 mm; median 9.4 vs. 6.9 months), and at least 3 metastatic disease sites (median 11.7 vs. 8.6 months).

Disclosure: Study authors’ disclosure information can be found at academic.oup.com.



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