ESMO 2016: Significant Survival Gains With Atezolizumab vs Docetaxel for Non–Small Cell Lung Cancer
The first phase III study of programmed cell death ligand 1 (PD-L1) inhibitor atezolizumab (Tecentriq) in previously treated non–small cell lung cancer has seen significant improvements in survival compared to standard chemotherapy, reported Barlesi et al at the European Society for Medical Oncology (ESMO) 2016 Congress in Copenhagen (Abstract LBA44_PR).
PD-L1 inhibitors are of a class of cancer immunotherapies called checkpoint inhibitors, and work by inhibiting one of the mechanisms of resistance developed by cancer cells in order to evade the immune system.
“The goal of this treatment is to allow the immune system to control and possibly eliminate cancer calls, so atezolizumab might be useful in a very large setting of different cancers,” said lead investigator Fabrice Barlesi, MD, PhD, Head of the Multidisciplinary Oncology and Therapeutic Innovations Department at Aix-Marseille University and the Assistance Publique Hôpitaux de Marseille, France.
OAK Trial
The OAK study enrolled 1225 patients with previously treated non–small cell lung cancer and, after stratifying them according to PD-L1 status, number of prior chemotherapy regimens, and histology, randomized them to intravenous atezolizumab (1,200 mg every 3 weeks) or docetaxel (75 mg/m2 every 3 weeks).
In the preliminary analysis of data from 850 patients, researchers saw a 27% improvement in overall survival in the patients receiving azetolizumab compared to those treated with docetaxel (P = .0003), regardless of their PD-L1 expression levels and including patients with PD-L1 expression of less than 1%.
When patients were stratified according to their level of PD-L1 expression, the overall survival was 59% greater among patients in the highest tertile of PD-L1 expression who were treated with azetolizumab, compared to the same group treated with docetaxel (P < .0001).
However, even in patients with no PD-L1 expression, there was still a significant 25% improvement in overall survival with atezolizumab compared to those treated with docetaxel. The improvements in overall survival were similar in patients with squamous and nonsquamous histology.
“This is the first phase III study of atezolizumab, a PD-L1 inhibitor, and it confirms the efficacy seen in the POPLAR phase II study, along with the results of PD-1 [programmed cell death protein 1] inhibitors,” said Dr. Barlesi.
“Azetizolumab offers a new second-line therapeutic strategy for patients with non–small cell lung cancer, regardless of the PD-L1 status of the tumor.”
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
