Adding Tecentriq (atezolizumab) to a combination of Avastin (bevacizumab) and chemotherapy extended the survival of metastatic non-squamous non-small cell lung cancer (NSCLC) patients, an early analysis of Genentech’s Phase 3 trial shows.
The multicenter, open-label, randomized IMpower150 trial (NCT02366143) assessed the safety and effectiveness of adding Tecentriq to Avastin and chemotherapy medications Taxol (paclitaxel) and carboplatin for the treatment of metastatic or recurrent NSCLC. The study enrolled 1,202 patients who had not previously been treated with chemotherapy.
Patients received either Tecentriq plus carboplatin and Taxol; Tecentriq and Avastin plus carboplatin and Taxol; or Avastin plus carboplatin and Taxol, which was the control group.
IMpower150 included a treatment-induction phase and maintenance treatment until disease worsening or loss of clinical benefit. During induction, Tecentriq was given intravenously at 1,200 mg and Avastin at 15 mg/kg on day one of a three-week treatment cycle for four or six cycles. On maintenance treatment, patients received Tecentriq and/or Avastin every three weeks.
Compared with patients treated with Avastin and chemotherapy only, those also receiving Tecentriq had increased overall survival (19.2 vs. 14.7 months). This benefit was observed across all patients, including those with mutations in the EGFR and ALK genes, and regardless of PD-L1 levels in their tumor cells. Patients with liver metastases also had extended survival.
The combination therapy showed similar safety results to each medication alone, and no new safety issues were identified. Serious adverse events related to treatment were found in 57% of people treated with the triple combination compared with 49% of those who received Avastin plus chemotherapy.
In contrast, treatment with Tecentriq and chemotherapy did not extend survival. Safety results of this combination were also consistent with the reported data from the individual treatments.
“The IMpower150 study results showed a significant survival benefit, adding to the clinical evidence supporting the combination of Tecentriq and Avastin as an initial treatment for metastatic non-squamous non-small cell lung cancer,” Sandra Horning, MD, chief medical officer and head of global product development at Genentech, said in a press release. “We are working with health authorities around the world to bring this potential Tecentriq combination regimen to people living with this disease.”
Genentech will present IMpower150 results on Monday at the 2018 American Society of Clinical Oncology Annual Meeting in a poster titled “Overall survival (OS) analysis of IMpower150, a randomized Ph 3 study of atezolizumab (atezo) + chemotherapy (chemo) ± bevacizumab (bev) vs chemo + bev in 1L nonsquamous (NSQ) NSCLC.” The meeting is taking place through June 5 in Chicago.
In May, the U.S. Food and Drug Administration granted priority review to this triple combination for first-line treatment of metastatic NSCLC. The agency is expected to make a decision on whether or not to approve it by Sept. 5.
Besides IMpower150, Genentech is conducting seven Phase 3 trials in lung cancer assessing Tecentriq alone or in combination with other medications.
