Pneumologie 2020; 74(S 01): 39
DOI: 10.1055/s-0039-3403148
Posterbegehung (PO07) – Sektion Pneumologische Onkologie
Immunonkologische Therapie beim Lungenkarzinom
Georg Thieme Verlag KG Stuttgart · New York

IMpower150: analysis of efficacy in patients (pts) with liver metastases (mets)

M Reck
1   Airway Research Center North (Arcn), Member of the German Center for Lung Research (Dzl); Onkologischer Schwerpunkt, Lungenclinic Grosshansdorf
,
R Jotte
2   Rocky Mountain Cancer Centers
,
F Cappuzzo
3   Azienda Unità Sanitaria Locale Della Romagna
,
T Mok
4   Chinese University of Hong Kong
,
H West
5   Swedish Cancer Institute
,
M Nishio
6   The Cancer Institute Hospital, Japanese Foundation for Cancer Research
,
VA Papadimitrakopoulou
7   The University of Texas MD Anderson Cancer Center
,
F Orlandi
8   Instituto Nacional del Torax
,
D Stroyakovskii
9   Moscow City Oncology Hospital
,
C Thomas
10   New England Cancer Specialists
,
N Nogami
11   National Hospital Organization Shikoku Cancer Center
,
F Barlesi
12   Aix Marseille University, Assistance Publique Hôpitaux de Marseille
,
A Lee
13   Genentech, Inc.
,
G Shankar
13   Genentech, Inc.
,
W Yu
13   Genentech, Inc.
,
M Ballinger
13   Genentech, Inc.
,
I Bara
13   Genentech, Inc.
,
A Sandler
13   Genentech, Inc.
,
M Socinski
14   Adventhealth Cancer Institute
› Author Affiliations
Further Information

Publication History

Publication Date:
28 February 2020 (online)

Also available at
 

Background: Atezolizumab (atezo) + bevacizumab (bev) + chemo (carboplatin + paclitaxel [CP]; ABCP) showed improved PFS and OS vs. bev + CP (BCP) in pts with chemo-naive NSCLC (IMpower150). Benefit with ABCP vs. BCP extended to key subgroups, including pts with baseline (BL) liver mets, which is a poor prognostic factor in metastatic NSCLC. Similar outcomes were not seen with atezo + chemo (IMpower150 [atezo + CP; ACP]; IMpower130; IMpower132), suggesting that the addition of bev to atezo + chemo is important for conferring clinical benefit in these pts. Here we further explore characteristics and responses of pts with BL liver mets in IMpower150.

Methods: 1202 ITT pts were randomized 1 : 1 : 1 to receive ABCP, ACP or BCP. Doses were: A, 1200 mg; B, 15 mg/kg; C, AUC 6 mg/mL/min; P, 200 mg/m2. Coprimary endpoints were OS and investigator-assessed PFS in ITT-wild-type pts. Exploratory analyses included efficacy and safety in pts with liver mets.

Results: The data capture ≥ 20-mo follow-up in ITT pts (data cutoff: Jan 22, 2018). 162 pts had BL liver mets (ABCP, n = 52; ACP; n = 53; BCP, n = 57), with a median of 3 metastatic sites and median BL tumor SLD of 109 mm (range, 10 – 249). BL characteristics in these pts were generally balanced across study arms. PFS and OS were improved with ABCP vs. BCP ([Table 1]). Gr 3 – 4 treatment-related AEs occurred in 52.1%, 36.5% and 54.5% of pts with liver mets in the ABCP, ACP and BCP arms, respectively.

Table 1 

Presence of liver mets

mPfS, mo

HR (95% CI)

ABCP

ACP

BCP

ABCP vs. BCP

ACP vs. BCP

a Pts with measurable disease at BL.

Yes

8.2 (n = 52)

5.4 (n = 53)

5.4 (n = 57)

0.41 (0.26, 0.62)

0.81 (0.55, 1.21)

No

8.4 (n = 348)

6.9 (n = 349)

7.0 (n = 343)

0.61 (0.52, 0.73)

0.90 (0.77, 1.06)

mOS, mo

HR (95% CI)

Yes

13.3 (n = 52)

8.9 (n = 53)

9.4 (n = 57)

0.52 (0.33, 0.82)

0.87 (0.57, 1.32)

No

20.4 (n = 348)

21.0 (n = 349)

17.0 (n = 343)

0.82 (0.66, 1.02)

0.84 (0.68, 1.04)

ORR, %a

Difference (95% CI), %

Yes

60.8 (n = 51)

26.9 (n = 52)

41.1 (n = 56)

19.7 (− 0.75, 40.18)

− 14.2 (− 33.65, 5.35)

no

55.8 (n = 346)

42.7 (n = 349)

40.1 (n = 337)

15.7 (8.03, 23.4)

2.6 (− 5.03, 10.29)

mDOR, mo

HR (95% CI)

Yes

10.7 (n = 31)

5.6 (n = 15)

4.6 (n = 23)

0.39 (0.21, 0.73)

0.59 (0.29, 1.23)

No

11.5 (n = 193)

9.2 (n = 149)

6.5 (n = 138)

0.43 (0.33, 0.55)

0.52 (0.40, 0.69)

Conclusions: ABCP reduced the risk of death in pts with liver mets by 48% vs. BCP and may represent an important new treatment option for this population.

NCT02366143