Atezolizumab Plus Chemotherapy Effective in Patients With Advanced Squamous NSCLC

The combination of atezolizumab plus chemotherapy improved progression-free survival (PFS) compared with chemotherapy alone in the first-line setting for patients with advanced squamous non-small cell lung cancer (NSCLC), according to a recent study supported by Genentech (IMpower131; March 19, 2018).

In a multicenter, randomized study, researchers evaluated the efficacy and safety of atezolizumab in combination with carboplatin and nab-paclitaxel or in combination with carboplatin and paclitaxel versus chemotherapy alone in patients with stage IV squamous NSCLC who have not been previously treated with chemotherapy.

Researchers noted that a total of 1,021 patients were included in the study and were randomized (1:1:1) to receive atezolizumab plus carboplatin and paclitaxel (arm A), atezolizumab plus carboplatin and nab-paclitaxel (arm B), or carboplatin and nab-paclitaxel alone (arm C).

During treatment-induction, arm A received four or six cycles of treatment. Atezolizumab and carboplatin were administered on day one of each 21-day cycle and nab-paclitaxel was administered on days one, eight, and 15. This regimen was followed by maintenance therapy with atezolizumab every three weeks until progression of the cancer, or for as long as clinical benefit was observed.

Arm B received four or six cycles of treatment. Atezolizumab and carboplatin were administered on day one of each 21-day cycle and paclitaxel was administered on days one, eight, and 15. This regimen was followed by maintenance therapy with atezolizumab every three weeks until progression of the cancer, or for as long as clinical benefit was observed.

Arm C received four or six cycles of treatment. Carboplatin was administered on day one of each 21-day cycle and nab-paclitaxel was administered on days one, eight, and 15. In the maintenance phase, participants received best supportive care.

The co-primary endpoints were PFS as determined by the investigator using RECIST v1.1 in the intention-to-treat (ITT) population, and overall survival in the ITT population.

Researchers reported that the combination of atezolizumab plus carboplatin and nab-paclitaxel reduced the risk of disease worsening or death compared with chemotherapy alone.