The results of the IPSOS clinical study show that the use of atezolizumab as first-line therapy significantly improved overall survival (OS) versus single-agent chemotherapy in patients with non-small-cell lung cancer (NSCLC). These findings were presented at the ESMO congress 2022.
Atezolizumab is an anti-PDL-1 immunotherapeutic drug. Its efficacy was evaluated in the treatment of patients with NSCLC.
The multicentre, global, open-label, randomized, phase-3, IPSOS study enrolled 453 patients (median age, 75 years) with locally advanced/metastatic NSCLC without driver mutations and were ineligible for first-line platinum-doublet chemo due to poor PS (≥2) or comorbidities in patients aged ≥70 yr. The participants were randomized (2:1) to receive either atezolizumab or single-agent chemotherapy (vinorelbine or gemcitabine). The study’s primary endpoint was OS whereas the secondary endpoints included OS rates, progression-free survival (PFS), overall response rate (ORR) etc.
After a median follow-up of 41 months, it was observed that atezolizumab significantly improved OS versus single-agent chemotherapy (stratified hazard ratio [HR] 0.78; 95% confidence interval [CI] 0.63–0.97; p=0.028). Its benefits were seen across key subgroups, including PD-L1 expression levels, performance status (PS) and histology. Clinical benefits were also seen in the two-year OS rate, ORR and DOR. Treatment-related adverse events (TRAEs) (grade ¾) were seen in 16.3% and 33% of patients in the atezolizumab and chemotherapy arms, respectively. Grade 5 TRAEs were observed in 1% and 2.7% of patients in the atezolizumab and chemotherapy arms, respectively.
The IPSOS is the first study that has evaluated the efficacy of single-agent immunotherapy in NSCLC patients with poor prognoses. The immunotherapy extended survival benefits with no new safety signals.
Lee SM, et al. IPSOS: Results from a phase 3 study of first-line (1L) atezolizumab (atezo) vs single-agent chemotherapy (chemo) in patients (pts) with NSCLC not eligible for a platinum-containing regimen. ESMO Congress 2022, LBA11