Atezolizumab may significantly improve survival in patients with previously treated non-small cell lung cancer (NSCLC) compared to docetaxel, according to a study published in The Lancet.1

Researchers led by Louis Fehrenbacher, MD, of the Kaiser Permanente Medical Center in Vallejo, CA, conducted an open-label, phase 2 randomized controlled trial of 144 patients treated with atezolizumab and 143 treated with docetaxel from 61 academic medical centers and community oncology practices across 13 countries in Europe and North America.

Primary endpoint was overall survival in the intention-to-treat population and anti-programmed death ligand 1 (PD-L1) subgroups, with biomarkers assessed in an exploratory analysis.

The study found that overall survival in the intention-to-treat population was 12.6 months for patients treated with atezolizumab and 9.7 months for those treated with docetaxel.

An increasing improvement in overall survival was found to be associated with increasing PD-L1 expression.

Upon exploratory analysis, patients with pre-existing immunity, defined by a high T-effector-interferon-y-associated gene expression were found to have an improved overall survival with atezolizumab.

Additionally, 11 patients in the atezolizumab group had to discontinue treatment due to adverse events, compared with 30 in the docetaxel group.

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“Improvement correlated with PD-L1 immunohistochemistry expression on tumor cells and tumor-infiltrating immune cells, suggesting that PD-L1 expression is predictive for atezolizumab benefit,” the authors concluded.

Reference

  1. Fehrenbacher L, Spira A, Ballinger M, et al. Atezolizumab versus docetaxel for patients with previously treated non-small-cell lung cancer (POPLAR): a multicentre, open-label, phase 2 randomised controlled trial [published online ahead of print March 9, 2016]. Lancet. doi: 10.1016/S0140-6736(16)00587-0.