Sivuonthanh Lam

First-Line Atezolizumab plus Chemotherapy in Extensive-Stage Small-Cell Lung Cancer

BACKGROUND Enhancing tumor‐specific T‐cell immunity by inhibiting programmed death ligand 1 (PD‐L1)–programmed death 1 (PD‐1) signaling has shown promise in the treatment of extensive‐stage small‐cell lung cancer. Combining checkpoint inhibition with cytotoxic chemotherapy may have a synergistic effect and improve efficacy. METHODS We conducted this double‐blind, placebo‐controlled, phase 3 trial to evaluate atezolizumab plus carboplatin and etoposide in patients with extensive‐stage small‐cell lung cancer who had not previously received treatment. Patients were randomly assigned in a 1:1 ratio to receive carboplatin and etoposide with either atezolizumab or placebo for four 21‐day cycles (induction phase), followed by a maintenance phase during which they received either atezolizumab or placebo (according to the previous random assignment) until they had unacceptable toxic effects, disease progression according to Response Evaluation Criteria in Solid Tumors, version 1.1, or no additional clinical benefit. The two primary end points were investigator‐assessed progression‐free survival and overall survival in the intention‐to‐treat population. RESULTS A total of 201 patients were randomly assigned to the atezolizumab group, and 202 patients to the placebo group. At a median follow‐up of 13.9 months, the median overall survival was 12.3 months in the atezolizumab group and 10.3 months in the placebo group (hazard ratio for death, 0.70; 95% confidence interval [CI], 0.54 to 0.91; P=0.007). The median progression‐free survival was 5.2 months and 4.3 months, respectively (hazard ratio for disease progression or death, 0.77; 95% CI, 0.62 to 0.96; P=0.02). The safety profile of atezolizumab plus carboplatin and etoposide was consistent with the previously reported safety profile of the individual agents, with no new findings observed. CONCLUSIONS The addition of atezolizumab to chemotherapy in the first‐line treatment of extensive‐stage small‐cell lung cancer resulted in significantly longer overall survival and progression‐free survival than chemotherapy alone. (Funded by F. Hoffmann–La Roche/Genentech; IMpower133 ClinicalTrials.gov number, NCT02763579.)

PS01.56: IMpower110: Phase III Trial Comparing 1L Atezolizumab with Chemotherapy in PD-L1–Selected Chemotherapy-Naive NSCLC Patients: Topic: Medical Oncology

Eric Vallieres, Enriqueta Felip, Nasser Altorki, Caicun Zhou, Yunxia Zuo, Michael Howland, Fan Xia, Tien Hoang, Alan Sandler, Heather Wakelee Swedish Cancer Institute, Seattle, WA/United States of America, Vall d’Hebron University Hospital, Barcelona/Spain, New YorkePresbyterian Hospital, Weill Cornell Medicine, New York, NY/United States of America, Tongji University Affiliated Shanghai Pulmonary Hospital, Shanghai/China, Roche (China) Holding Ltd, Shanghai/China, Genentech, Inc., South San Francisco, CA/United States of America, Stanford Cancer Institute, Stanford/United States of America