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ASCO Oral: Landmark study rings in the first immune-based therapy for patients with resected, high-risk early-stage non-small cell lung cancer

 

  • Selected by the American Society of Clinical Oncology (ASCO) as an Oral Presentation during its 2021 Virtual Annual Meeting, 04 – 08 June, primary results from the phase III IMpower010 global trial show that treatment with an immune checkpoint inhibitor improves disease-free survival in patients with resected, stage II-III, non-small cell lung cancer (NSCLC).
  • Demonstrating improved disease-free survival compared to best supportive care, this pivotal trial is the very first phase III study to evidence the efficacy of immunotherapy atezolizumab in this patient population. 
  • Administered as adjuvant therapy following surgery and chemotherapy, atezolizumab showed improved disease-free survival in stage II-IIIA randomized patients, with greater benefit observed in the PD-L1-positive subgroup. 

 

Barcelona, June 3, 2021 –

With an estimated 2.2 million new cancer cases and 1.8 million deaths in 2020, lung cancer is the second most commonly diagnosed cancer and the leading cause of death from cancer, representing approximately one in 10 cancers diagnosed and one in 5 deaths (1). Non–small cell lung cancer (NSCLC) is the most prevalent type and accounts for approximately 84% of all lung cancers(2)

Considering these statistics, there is a critical need to seek out and develop more potent treatment opportunities aimed at treating lung cancer, especially in the early-stage setting. The phase III, global, open-label, randomized IMpower010 trial(3), enrolling 1280 participants across 231 sites, including the Vall d’Hebron Institute of Oncology (VHIO), was designed to assess the efficacy and safety profile of immune checkpoint inhibitor (ICI) atezolizumab as adjuvant therapy in patients with resected, high-risk early-stage NSCLC. 

Directed by Heather A. Wakelee, Stanford University Medical Center (CA, USA), and co-led by Enriqueta Felip, Principal Investigator of VHIO’s Thoracic Tumors Group, IMpower010 compared treatment with atezolizumab to best supportive care (BSC). Following surgical resection and adjuvant chemotherapy, a total of 1005 patients were randomized 1:1 to receive either 16 cycles of atezolizumab or BSC. 

Selected by the American Society of Clinical Oncology (ASCO) as an Oral Presentation(4), results showed that IMpower010 achieved its primary endpoint. Strikingly, treatment with atezolizumab showed a statistically significant DFS improvement in stage II-III NSCLC patients, with even greater benefit observed in the PD-L1-positive subgroup. 

In PD-L1 expressers, the two-year DFS rate was 74.6% for atezolizumab versus 61.0% for best supportive care. The overall risk of disease recurrence was reduced by 34% with atezolizumab, with a statistically significant p value of 0.004. Importantly, the safety profile was consistent with other previous studies of atezolizumab monotherapy across indications and lines of therapy. 

These positive findings show that atezolizumab after adjuvant chemotherapy may offer a promising treatment option that extends DFS in patients with resected Stage II-IIIA NSCLC, particularly in people whose tumors express PD-L1. 

 “These results open up a new therapeutic avenue for these patients. They also shine important light on more effectively treating high-risk cancer in the early-stage setting before it spreads, as well as potentially preventing the recurrence of disease,” concluded Enriqueta Felip, co-lead author of this present study, Head of the Thoracic Cancer Unit, Vall d’Hebron University Hospital (HUVH – Vall d’Hebron Barcelona Hospital Campus), and Vice President, Spanish Society of Medical Oncology (SEOM).

IMpower010 is supported by the pharmaceutical company F. Hoffmann-La Roche Ltd. 

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References

  1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018 Nov;68(6):394-424. https://acsjournals.onlinelibrary.wiley.com/doi/full/10.3322/caac.21492.
  2. Key Statistics for Lung Cancer. American Cancer Society. Last revised: January 12, 2021. https://www.cancer.org/cancer/lung-cancer/about/key-statistics.html.
  3. Study to Assess Safety and Efficacy of Atezolizumab (MPDL3280A) Compared to Best Supportive Care Following Chemotherapy in Patients With Lung Cancer (IMpower010). NCT02486718. 
  4. American Society of Clinical Oncology’s (ASCO), 2021 Virtual Annual Meeting, 04 – 08 June.

Abstract 8500. IMpower010: Primary results of a phase III global study of atezolizumab versus best supportive care after adjuvant chemotherapy in resected stage IB-IIIA non-small cell lung cancer (NSCLC). https://meetinglibrary.asco.org/record/195950/abstract.

07/06/2021|