ASCO 2018: Addition of Immunotherapy to Chemotherapy for Advanced Squamous NSCLC
Posted: Wednesday, June 6, 2018
Patients with advanced squamous non–small cell lung cancer (NSCLC) have longer progressive-free survival when initially treated with the PD-L1–targeted atezolizumab and chemotherapy versus chemotherapy alone, according Robert M. Jotte, MD, PhD, of Rocky Mountain Cancer Centers in Denver, and colleagues. The results of the randomized phase III IMpower131 trial were presented at the 2018 American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago (Abstract LBA9000).
“Until now, there have been few treatment advances for squamous NSCLC,” stated Dr. Jotte in an ASCO press release. “Our findings may provide a new potential treatment option for this type of cancer. Growing research, including this study, shows that chemotherapy can help trigger the immune response to the tumor, helping the immunotherapy work better.”
The trial enrolled 1,021 patients with stage IV squamous NSCLC. They were assigned to one of three treatment groups, including 343 patients who received atezolizumab plus chemotherapy (carboplatin and nab-paclitaxel) and 340 patients who received chemotherapy (carboplatin and nab-paclitaxel) alone. Outcomes are not yet available for the third treatment arm (atezolizumab with carboplatin and paclitaxel). Participants were included in the trial regardless of the PD-L1 expression level.
Dr. Jotte and colleagues found that patients receiving atezolizumab plus chemotherapy had a longer median progression-free survival than those who received chemotherapy alone (6.3 months vs 5.6 months, P = .0001). Additionally, 24.7% of patients treated with immunotherapy plus chemotherapy had a progression-free survival benefit at 12 months, compared with 12% of those receiving chemotherapy alone.
As for toxicity, the rate of grade 3 and 4 treatment-related adverse events was 68% with the combined-modality treatment and 57% with chemotherapy alone. These data were consistent with the known safety risks of the individual therapies.
